SHOULDER-HAND SYNDROME FOLLOWING MYOCARDIAL INFARCTION

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Abstract
Reflex dystrophy of the upper extremity, often producing serious disability, has been receiving increased attention in recent years. Although the syndrome is due to many different causes, the underlying neurovascular mechanism is probably the same. This paper is concerned with a description of a technic for procaine block of the stellate ganglion using the anterior approach and the results obtained in treatment of the shoulderhand syndrome following myocardial infarction. Many cardiologists and other clinicians from Osler1 on have noted the onset of a painful disability of the shoulder or hand or both following myocardial infarction or long-standing angina pectoris. Libman2 noted the frequent coexistence of painful shoulder and angina pectoris, but he erroneously attributed the pain to "subacromial bursitis." Ernstene and Kinell,3 in a study of 133 cases of myocardial infarction, found the occurrence of persistent shoulder pain in 17, and in six of these there was

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