Document Detail


Recurrent intraoperative coronary artery spasm in a patient with coronary artery aneurysm.
MedLine Citation:
PMID:  17126783     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Coronary artery spasm (CAS) may result from endothelial dysfunction in nonobstructed arteries. Its complications include myocardial infarction, dysrhythmias, and death. It is difficult to diagnose CAS during general anesthesia because it closely mimics obstructive ischemia. We report the case of a patient who demonstrated intraoperative CAS during two separate surgeries. Angiography after the first surgery showed nonobstructed coronary anatomy. During the second surgery, recurrence of acute ST elevations caused by CAS rapidly responded to nitroglycerin. A high index of suspicion for CAS as a cause of intraoperative ischemia is necessary for an early diagnosis, treatment, and a favorable outcome.
Authors:
Angela T Truong; Dam-Thuy Truong; David L Brown
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  18     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-27     Completed Date:  2007-03-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  530-3     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Pain Medicine, University of Texas at Houston, Houston, TX 77030, USA. atruong@mdanderson.org
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MeSH Terms
Descriptor/Qualifier:
Coronary Aneurysm / complications,  surgery*
Coronary Vasospasm / diagnosis,  drug therapy*,  etiology
Female
Humans
Intraoperative Complications / diagnosis,  drug therapy*,  etiology
Middle Aged
Myocardial Infarction / diagnosis,  drug therapy,  etiology
Nitroglycerin / administration & dosage*
Vasodilator Agents / administration & dosage*
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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