Document Detail


Angiographic documentation of coronary artery spasm induced by anesthesia.
MedLine Citation:
PMID:  20339883     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Many cases of coronary artery spasm during regional or general anesthesia have been reported. To our knowledge, for the first time we report a case of coronary artery spasm induced by general anesthesia that was documented by immediate angiography and treated with intracoronary nitroglycerine. A 68-year-old female was to undergo elective cholecystectomy. General anesthesia was induced by propofol 140 mg, fentanyl 50 microg, and vecuronium bromide 7 mg. Immediately after intubation sudden hypotension (60/40 mmHg) and marked ST-segment elevation on the monitor were noticed. A 12-lead electrocardiogram demonstrated marked ST-segment elevations in inferior leads with reciprocal changes. An immediate diagnostic coronary angiography showed diffuse severe narrowing of the right coronary artery with a non-critical plaque in the midportion. After intracoronary administration of nitroglycerine 0.2 mg into the right coronary artery, there was marked diffuse vasodilatation. A diagnosis of variant angina was made and 2 days of hospital course was uneventful. The patient was discharged taking diltiazem 120 mg two times daily, aspirin 100 mg daily and isosorbidemononitrate 60 mg daily.
Authors:
Ender Ornek; Dilsen Ornek; Sani Namik Murat; Murat Turfan
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-03-26
Journal Detail:
Title:  Journal of anesthesia     Volume:  24     ISSN:  1438-8359     ISO Abbreviation:  J Anesth     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-14     Completed Date:  2010-09-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  452-5     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Etlik Ihtisas Education and Research Hospital, Halil Sezai Erkut Caddesi Etlik, Ankara, Turkey. ender_ornek@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Anesthesia, General / adverse effects*
Angina Pectoris / drug therapy,  radiography
Cholecystectomy
Coronary Angiography / methods*
Coronary Vasospasm / chemically induced*,  radiography*
Electrocardiography
Female
Humans
Hypertension / complications
Intraoperative Complications / chemically induced*,  drug therapy,  radiography*
Monitoring, Intraoperative
Nitroglycerin / therapeutic use
Vasodilator Agents / therapeutic use
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 55-63-0/Nitroglycerin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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