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Summary
In this chapter we illustrate that cardiac nociceptive processing
exists in the upper cervical (C1-C2) segments and upper thoracic
(T1-T4) segments.
Vagal afferents
might have a pivotal function in this control system.
Electrical
activation of either the C1-C2 or upper thoracic spinal levels,
or stimulation of the vagus nerves, may all modulate nociceptive
afferents from the heart.
Further exploration
of the organization of spinal control of coronary function seems
important in order to develop new, effective and less invasive
therapies for the treatment of patients with ischemically compromised
hearts who do not benefit from the standard revascularization
procedures aided by optimal pharmacotherapy.
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