Krassioukov et al[30] found an incidence of early AD of 5.2% in a population of acute SCI, the earliest episode of AD occurred on the 4th post-injury day. Patients with cervical or thoracic injuries above Th4 may have disrupted the sympathetic afferent fibres including cardiac pain fibres; their sensation of ischemic cardiac pain may be changed (referred pain) or absent[31].