Abstract
We present two cases in which elderly male recreational cyclists suffered from cervical fractures and coinciding injuries of the spinal cord that subsequently led to cardiac arrest.Based on reports from eye witnesses and due to the low impact nature of the crashes, the two patients were initially considered as having cardiac arrest before falling of their bikes.The spinal cord injuries triggering cardiac arrest were acknowledged with delay, as the primary eliciting cause was considered cardiac disease in conjunction with all-out exercise. We suggest that increased focus should be made on possible cervical injuries even following low energy crashes in road cycling.
Highlights
Middle-aged or elderly men performing recreational cycling are over-represented in the group of patients presenting with exercise-related severe cardiovascular events [1]
Both men were later diagnosed with cervical fractures, cervical cord injury (CCI) being identified as the eliciting cause of cardiac arrest
The two cases presented here are reported from two different prehospital units and two different hospitals in the Region of Southern Denmark. Both cases demonstrate that considerations pertaining to traumatic injury are not necessarily the first considerations made when cardiac arrest is encountered in conjunction with what may be perceived as low-energy trauma
Summary
Middle-aged or elderly men performing recreational cycling are over-represented in the group of patients presenting with exercise-related severe cardiovascular events [1]. In general, it is reasonable to assume that in this population of cyclists, the eliciting cause is exercise-related, when they are found with cardiac arrest on the road next to the bicycle We present two cases of middle-aged or elderly men with suspected exercised-induced cardiac arrest following seemingly innocent falls in recreational road cycling. Both men were later diagnosed with cervical fractures, CCI being identified as the eliciting cause of cardiac arrest. The patient was immediately inline-stabilised and transferred to the trauma unit at the regional university hospital He was admitted at the neurosurgical department, presenting no signs of autonomic dysfunction. The cause of cardiac arrest could not be established with complete certainty, no other plausible cause than acute CCI could be found
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