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Coronary artery spasm after coronary artery bypass grafting
M Caputo1, F Nicolini, G Franciosi
1Department of Cardiac Surgery, Istituto Clinico Humanitas, Milan, Italy.
Insights
Postoperative coronary artery spasm can cause severe symptoms like ST elevation and hypotension after coronary artery bypass grafting. Prompt diagnosis and treatment with nitroglycerine and verapamil effectively resolved the spasm in this case.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Coronary artery bypass grafting (CABG) is a common surgical procedure.
- Postoperative complications can arise despite successful grafting.
Observation:
- A 62-year-old man presented with severe postoperative coronary artery spasm.
- Manifestations included ST segment elevation, hypotension, and echocardiographic wall motion abnormalities.
Findings:
- Urgent coronary angiography confirmed the diagnosis of coronary artery spasm.
- Intracoronary infusion of nitroglycerine and verapamil successfully relieved the spasm.
Implications:
- This case highlights a rare but serious complication following CABG.
- Early recognition and targeted pharmacologic intervention are crucial for managing postoperative coronary artery spasm.
Abstract:
We report a case of a 62-year-old man with severe manifestations of postoperative coronary artery spasm following effective coronary artery bypass grafting. The coronary artery spasm was manifested by ST segment elevation, hypotension and wall motion abnormalities on echocardiography. Urgent angiography confirmed the diagnosis and intracoronary infusion of nitroglycerine and verapamil relieved the coronary spasm.