Cardiovascular (Heart)
“Shortly after this relief from deafness,
I had a patient complaining of heart trouble which was not
which was not improving. I examined the spine and found a
displaced vertebrae pressing against the nerves which innervate
the heart. I adjusted the vertebra and gave immediate relief
-- nothing ‘accidental’ or ‘crude’ about
this. Then I began to reason that if two diseases, so dissimilar
as deafness and heart trouble, came from impingement, a pressure
on nerves, were not other diseases due to a similar cause?”
D.D.
Palmer, (Discoverer of Chiropractic) in The Chiropractors Adjuster.
Portland Printing House, Portland, Oregon, 1910
Spine and heart,
vertebrogenous cardiac syndromes. Egli, AB Ann Swiss Chiro
Assoc 4:95-105, 1969.
The “flat thoracic spine” or “straight
back syndrome” is described as accompanying heart murmurs,
pulmonary problems, and other forms of cardiopulmonary disease.
A
somatic component to heart disease. Koch RS: Journal of the
American Osteopathic Association 60:735-739, 1961.
Numerous
observations reveal that upper thoracic subluxations are common
in heart patients; the subluxations appeared months or years
before the cardiac symptoms. Koch reports that many heart patients
reported heart disease following thoracic trauma with marked
subjective and objective improvement following spinal care.
Out
of 150 cases, no cardiac deaths occurred during the spinal
corrective program.
The straight thoracic spine in cardiac diagnosis.
Gooch AS, Maranhao, Goldberg H, Am Heart J 74:595-602, 1967.
Compression
of the heart and great vessels by a chest deformity (with absence
of normal thoracic kyphosis) is called the “straight
back syndrome.” This deformity simulates organic heart
disease by causing systolic murmurs, alterations of heart
sounds, and an apparent enlargement of the cardiac silhouette.
The
straight back syndrome: clinical cardiovascular manifestations.
DeLeon AC, Perloff JK, Twigg H. Circulation 32:193-203. 1965
Abnormalities
of thoracic configuration can alter the information derived
from clinical assessment of the heart. Although these alterations
may be subtle, occasionally they may be sufficiently overt
to produce signs that closely mimic organic heart disease.
Straight
back syndrome: a new heart disease. Rawlings ME, Dis Chest
39:435-443, 1961.
The “straight back” syndrome is
a heretofore unrecognized deformity of the chest causing pseudo-heart
disease.”
Reflex and vertebrogenic disorders in ischemic
heart disease, their importance in therapy. Rvchlikova E, Rehabilitacia
8:109-114. 1975.
This is a study of 260 patients that explored
the relationship between midthoracic subluxation (specifically
T4-6) and angina pain. It was found that patients having myocardial
infarction without prominent angina pain had subluxation patterns
similar to healthy controls; however, those with significant
cardiac pain appeared to have a high prevalence of T4-6 subluxation.
Osteopathic
manipulative therapy in organic heart disease. Roebuck SV,
Yearbook of the American Academy of Osteopathy 1965.
“During
the period of emergency and many times after the period of
emergency, the difference in success and failure may be determined
by a timely and efficiently applied osteopathic manipulative
therapy.”
Respiratory manifestations of dorsal spine radiculitis
simulating cardiac asthma. Davis D. Annals of Internal Medicine
1950 22: (5) 954-959.
Dorsal spine radiculitis causes substernal
and precordial pain which simulates coronary occlusion. Included
in the symptoms is the inability to take a deep breath. Three
cases are discussed. One patient felt that her chest felt “fixed.” The
patients were placed on traction and showed some improvement.
The
role of palpatory diagnosis and manipulation therapy in heart
disease. Tilley RM Osteopathic Ann 4:272-277, 1976.
The author
stresses that all patients with heart disease: acute, chronic
and emergency should receive spinal care.
Palpatory testing
for somatic dysfunction in patients for cardiovascular disease.
Beal M, Journal of the American Osteopathic Association 82:822-831,
1983
The author found 108 patients with upper thoracic subluxations
commonly associated with heart disease. Spinal palpation
alone was 76% accurate in “indicating the presence
of cardiac disease.” Data from 21 studies demonstrated
the presence of T1-4 subluxations in cases of heart disease.
Short-term
power spectrum analysis of heart rate variability of chiropractic
students in college. Zhang, J. Chiropractic Research Journal,
Vol. Vll, No. 2, Fall 2000
Heart rate variability (HRV) is a
new way of measuring the relative health of the autonomic nervous
system (ANS). The ANS regulates the function of internal organs.
In
this study 27 students, aged 22 to 49 years old had their HRV
measured 4 times in a 12 month period. After one year of chiropractic
care a significant decrease in heart rate and increase in sympathetic
system activity was noted.
Improvements of cardiac autonomic
regulation following spinal manipulative therapy. Jarmel ME,
Zatkin JL, Charuvastra E, Shell WE. Presented at the July 1995
Chiropractic Centennial event in Washington, DC.
Sudden cardiac
death may arise from abnormal nerve firings. The author proposes
that mechanical irritation of upper thoracic vertebral joints
may cause abnormal heart nerve firings.
In this study, eleven
patients without a prior history of myocardial infarction who
had signs of heart rhythm abnormalities received “spinal manipulative therapy.” After
one month, heart rhythm and function improved. The author
writes “Spinal manipulative therapy significantly enhance(s)
cardiac autonomic balance.”
Effects of spinal manipulative
therapy on autonomic activity and the cardiovascular system:
a case study using the electrocardiogram and arterial tonometry.
Driscoll MD, and Hall MJ.J Manipulative Physiol Ther October
2000, Vol. 23 No. 8. (545-50)
ECG (electrocardiogram) and AT
(arterial tonometry) data was used to study the effects of
chiropractic care on the autonomic and cardiovascular systems.
The patient was seen twice a week for six weeks. Changes in
the relationship between the sympathetic and parasympathetic
nervous systems were observed.
Systemic effects of spinal lesions.
Dhami MSI, DeBoer KF In Principles and Practice of Chiropractic,
2nd edition, Appleton and Lange, East Norwalk, CT 1992.
The
authors list “organic disorders reported to be
related to spinal lesions or affected by chiropractic manipulation.” These
include: abdominal discomfort, asthma, Barre-Lieou syndrome,
cardiac arrhythmia, colic, constipation, dysmenorrhea, high
blood pressure, low-blood sugar and hyperinsulinism, migraine,
pulmonary diseases, ulcers, vertebral autonomic dysfunction.
ECG
improvements following the treatment combination of chiropractic
adjustments, diet, and exercise therapy. Lott GS, Sauer AD,
Wahl DR, Kessinger J. Chiropractic: The Journal of Chiropractic
Research and Clinical Investigation Vol. 6 No. 2, July 1990.
This
paper presents the effects of chiropractic adjustments on the
cardiac dysfunctions of four people as monitored by ECG. Patients
with varying symptoms had a baseline ECG taken and received
chiropractic adjustments. A follow-up ECG showed three of the
four patients improved. They also reported lowered blood pressure,
decreased ischemia of the myocardium, and better sleep habits
accompanying the improved ECG readings.
Cervical angina. Jacobs
B. Spinal Manipulation October 1990;90:8-11.
Cervical angina
(also known as pseudo angina) resembles true angina pectoris
but is the result of cervical spondylosis and nerve root compression.
This is the report of 164 patients (103 men and 61 women) 45
to 68 years of age and cared for over a 22-year period. Most
had been seen by at least two cardiologists prior to diagnosis.
Symptoms common to all patients but in varying severity, included
neck pain and stiffness, occipital headache and arm pain with
sensory symptoms. The majority of patients responded satisfactorily
to a standard nonsurgical regimen such as use of a hard collar,
intermittent traction, isometric exercise and a combination
of anti-inflammatory and muscle relaxant medications.
Relation
of dorso-cervical posture deficiencies to cardiac disease,
especially from middle life onwards. Cyriax E. Research Quarterly
7:74-77 Dec. 1936
In this paper the author discusses associations
between dorso-cervical posture and cardiac disease.
Cardiovascular
functional disorder and distress among patients with thoracic
outlet syndrome. Gockel M, Lindholm H, Vastasmaki M et al.
Journal of Hand Surgery (British and European Volume, 1995
20B: 29-33.
Cardiovascular function of 11 women with thoracic
outlet syndrome (TOS)...was studied. It was found that TOS
patients’ symptoms
included higher sympathetic tone. “The pathology of
TOS is pain at rest, effort pain; weakness and paraesthesia
of the upper limb are unknown.” Often a broader pathology
than irritation or compression of the brachial plexus or
subclavian artery or vein in the region of thoracic outlet
is involved....”
Comments by Dr. Koren: In reviewing this article from a
chiropractic perspective, the phrase “So near and yet
so far” comes to mind. I am constantly amazed that
at this date the relationship of the structural system to
functional health is often entirely overlooked. In this paper,
the authors return to the medical bias, that if they cannot
treat it medically then it must be, at least in part, a psychological
problem
Influence of a cervical mobilization technique on respiratory
and cardiovascular function. McGuiness J, Vicenzino B, Wright
A. Manual Therapy, Nov. 1997; 2(4), pp.216-20.
This study involved a non-chiropractic manipulation to pain-free
volunteers to see if the sympathetic nervous system would
be affected.
The researchers found a significant increase in
respiratory rate, heart rate, systolic and diastolic blood
pressure occurred during application of the technique to
C5/6, when compared to control and placebo conditions.
Comments
by Dr. Koren: the presence of a subluxation was not determined
nor was the correction of a subluxation determined. This research
showed that there was a relationship between autonomic function
and spinal integrity.
Functional Disorders of Internal Organs
Due to Vertebral Lesions, Kunert W (1965) CIBA Symposium 13(3):
85-96.
Kunert, a German cardiologist has written that spinal
examination should be performed for individuals with presumed
cardiac pain. He writes: “…lesions of the spinal column…are
perfectly capable of simulating, accentuating or making a
major contribution to organic diseases. There can…be
no doubt that the state of the spinal column does have a
bearing on the functional status of the internal organs.”
Somatic
dysfunction and the phenomenon of visceral disease simulation:
a probable explanation for the apparent effectiveness of somatic
therapy in patients presumed to be suffering from true visceral
disease. Nansel D, Szlazak M, Journal of Manipulative and Physiological
Therapeutics 1995;18:379-397.
This is a review of over 350 papers
over 75 years on “vertebral
lesions” and their relationship to visceral disease.
The
authors feel that patients do not experience true “organic” disease
healing after spinal care, rather the authors believe that “vertebral
lesions” were mimicking organic disease. This is an
assumption on their part which has not been proved. Indeed,
over 100 years of chiropractic clinical successes for many
organic diseases, plus many centuries of spinal care success
for preventing organic disease undermine their hypothesis.
Spondylotic
change of the cervical spine and coronary infarction. Bruckman
W. Deutsche Medizinische Wochenschrift 1956; 44:1740
The relationship
between cervical spondylosis and coronary infarction is discussed.
Segmental thoracic pain in patients admitted to a medical department
and a coronary unit. Bechgaard P. Acta Med Scand Suppl, 1981:644:87-89.
The
author estimates that 10% of the patients at his coronary unit
have somatic mimicry rather than true angina.
Back problems
and atherosclerosis. The study of osteoporotic fractures. Vogt
MT, Nevitt MC, Cauley JA. Spine, Dec. 1997; 22(23), pp.2741-7.
In
this study of 1,492 elderly women, those with cardiovascular
disease were more likely to have back pain and disability
as a result of the back pain than those women free of cardiovascular
disease.
Back-related disability was more than twice as likely
to have worsened in the cardiovascular disease group. Back
problems in elderly women are associated with self-reported
cardiovascular disease, but not with objectively assessed lower-extremity
arterial disease.
Cervical Angina. Wells P. American Family
Physician, 1997;55:2262-2264
Cervical angina is chest pain that
resembles true cardiac angina but originates from a cervical
discopathy with nerve root compression. This condition is also
called pseudo angina and often is caused by compression of
the C7 nerve root.
This is the case of a 48 year old woman who
suffered from chest pain, nausea and shortness of breath of
two weeks duration. An MRI showed a disc herniation. After
being treated with physical therapy, a cervical collar and
drugs, her symptoms reduced by 70-80%. (Imagine if she got
an adjustment).
The impact of chiropractic care on established
cardiac risk factors: a case study. Childs, N., Freerksen S
and Plourde A. Chiropractic: the J of Chiropractic Research
and Clinical Investigation. Vol. 8 No. 2, July 1992.
The purpose
of this study was to relate the possible effects of regular
chiropractic care to changes in lipid metabolism in a group
of subjects exposed to a stressful environment. Ten chiropractic
students (five males and five females, ages 22-38) were monitored
for total cholesterol, high density lipoprotein (HDL), and
cholesterol/HDL ratio or cardiac risk factor (CRF) over a period
of one to three years. All of the ten students studied obtained
marked reductions in the CRF during the duration of the study.
Palpatory
musculoskeletal findings in coronary artery disease: results
of a double-blind study. Cox JM, Rogers FJ, Gorbis, SL et al.
Journal of the American Osteopathic Association. July 1981
Vol. 80.
Eighty eight patients underwent cardiac catheterization
and within one week of angiography they underwent a standardized
musculoskeletal examination. A high correlation was found
between coronary atherosclerosis and abnormalities of range
of motion and soft tissue texture in the 4th and 5th thoracic
vertebrae and the 3rd cervical vertebrae alone. The authors
view this as a “viscerosomatic reflex” that may
be useful in cardiac diagnosis.
Copyright 2004 Koren Publications,
Inc. & Tedd Koren,
D.C.
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