An error in interpretation and real extraordinary electrocardiographic changes in patient with acute traumatic spondylolisthesis

BACKGROUND: Acute cervical spinal trauma may lead to cardiac effects by influencing cardiac sympathetic preganglionic fibers. Some of these effects, which are vital, may occur in ECG. CASE PRESENTATION: A 52-year-old female patient admitted to the emergency department with acute traumatic spondylolisthesis at C6-C7 level and paraplegia. Positive QRS complex, ST segment depressions and prolongation of QTc interval were observed on ECG according to sudden autonomic disruption because of sympathetic nerve compression. It was mentioned that changes in QRS complex axis was normal which was dependent to the ECG display format of Cabrera sequence used differently from the classical system. After surgical correction, evident ST depressions were recovered and QTc intervalwas narrowed but still prolonged in control ECG. CONCLUSIONS: Autonomic dysfunction can lead to extraordinary electrocardiographic presentation including widespread ST depressions with prolonged QTc interval. However, when evaluating the changes in the ECG, attention should be paid to ECG display format to avoid errors in interpretation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43044-022-00301-w.