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Speculation
on angina pain sensation
The propriospinal
pathways that are likely utilized by cardiac sympathetic afferents
to excite upper cervical neurons and by cardiac vagal afferents
to inhibit upper thoracic neurons may create a sort of spinal
pattern generator (Figure
8).
The balance
of ascending versus descending neural activity in this system
may ultimately determine whether noxious input from the heart
is transmitted to higher centers in the brain stem or cerebral
cortex, and finally determine the sensations experienced by the
individual.
Currently
this idea is speculation, for neither the anatomical pathways
nor the physiological interactions among them have been confirmed.
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