Autonomic dysreflexia: An important cardiovascular complication in spinal cord injury patients

Autonomic dysreflexia (AD) is a life-threatening complication of spinal cord injury (SCI) at T6 or above that results in an uncontrolled sympathetic discharge in response to noxious stimuli. It is a symptom complex characterized by a lethal rise in blood pressure with dangerous consequences. Autonomic dysreflexia is often secondary to urological, gastrointestinal, or gynecological problems or manipulations. Early recognition and prompt treatment of AD is vital to prevent complications, including death. Its management starts primarily with its prevention. Easy measures can avoid this high risk event, and physicians should be aware of the simple procedures and the possible treatment cascade that could be undertaken. The purpose of this systematic review is to review the clinical data on the mechanisms and pathophysiology of this condition and the clinical evidence about the various strategies currently used to prevent and manage AD in the SCI population; and to improve awareness of AD among cardiologists, family physicians and medical personnel in the emergency department.