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Coronary spasm during outpatient fiberoptic laser bronchoscopy
1Department of Anesthesiology and Critical Care Medicine, Hadassah University School of Medicine, Jerusalem, Israel.
Chest
|June 23, 1999
Summary
A patient undergoing bronchoscopy for breast cancer developed heart problems due to coronary artery spasm. This case highlights a rare complication during the procedure, emphasizing the need for cardiac monitoring.
Area of Science:
- Cardiology
- Pulmonology
- Oncology
Background:
- A 63-year-old woman with metastatic breast cancer underwent fiberoptic bronchoscopy for endobronchial mass laser resection.
- The patient had no prior history of ischemic heart disease, making the subsequent cardiac event unexpected.
Observation:
- During the bronchoscopy, the patient exhibited ST-segment elevation and a complete atrioventricular block.
- Immediate treatment with intravenous nitroglycerin and morphine successfully managed the cardiac episode.
Findings:
- Post-procedure coronary angiography revealed focal coronary artery spasm as the cause of the cardiac event.
- This suggests a potential link between bronchoscopic procedures and acute coronary events in susceptible patients.
Implications:
- This case underscores the importance of considering coronary artery spasm as a potential complication during fiberoptic bronchoscopy, even in patients without traditional cardiac risk factors.
- Enhanced vigilance and cardiac monitoring may be warranted for patients undergoing similar procedures.
- Further research could explore the mechanisms linking bronchoscopy to coronary vasospasm.