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Neural Mechanisms of Cardiac Pain
Author Biography
Introduction
Anterolateral System
Somatic vs. Visceral Nociceptive Processing
Angina Pectoris
Sympathetic Sensory Innervation
Referred Pain
Vagal Sensory Innervation
Other Ascending Pathways
Central Sensitization
Thalamus and Cerebral Cortex
Neurophysiology of Angina Pectorsis
Currently selected section: Nausea and Vomiting

Dyspnea
Summary

 

Chapter 25:Neural Mechanisms of Cardiac Pain: Nausea and Vomiting
        

Nausea and Vomiting

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Figure 13: Major Emetic Regions in the Medulla, and Possible Pathways from the Heart that Might Mediate Nausea and Vomiting During Angina Pectoris: Graphic depiction of major emetic regions in the medula, described in text

Angina pectoris is commonly accompanied by feelings of nausea and sometimes vomiting. What are the mechanisms for these responses? The short answer is that no one knows for certain.

Perhaps surprisingly, the mechanisms involved in vomiting (emesis) are still not completely determined, and the mechanisms of nausea are even less understood. Considering the importance of these responses to many pathological conditions, further research on the mechanisms is needed.

There are two major sites that initiate the process of emesis (Figure 14) (Hornby, 2001):

  •  Vagal afferents from the gastrointestinal tract; and
  •  The chemoreceptor trigger zone in the medulla.

These two sites will be explored in detail in the screens that follow.

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