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Abstract Summery & Conclusion Traumatic Spinal cord injuries (TSCI) are devastating conditions with far-reaching physical, emotional, and economic consequences for patients, families, and society at large.[2] In 2016, there were 0·93 million (0·78–1·16 million) new cases of SCI, and, the number of prevalent cases of SCI was 27·04 million (24·98–30·15 million) worldwide..[5, 6] The human heart receives a balanced innervation from sympathetic and parasympathetic fibers (4). The sympathetic preganglionic fibers run through the spinal cord and exit at levels T1– T4 to form synapses in the thoracic ganglia. from here, the sympathetic postganglionic fibers exit to innervate the heart where they are responsible for increasing HR and cardiac output.[3] It is well known that acute cervical traumatic spinal cord injury (SCI) may cause cardiovascular challenges including changes of blood pressure and heart rate (HR) with arrhythmias and these issues remain a challenge to the clinician.[171] Although neurogenic bowel, neurogenic bladder and sexual dysfunction are commonly recognized autonomic dysfunctions among spinal cord-injured individuals, cardiovascular disorders due to loss of supraspinal control of the sympathetic nervous system are also common and limiting.[1, 184] Baseline low systemic blood pressure, orthostatic hypotension and episodes of sudden increase in blood pressure (that is, autonomic |