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[Repeated coronary artery spasm under general anesthesia].

Tadashi Matsuura1, Youko Matsuo, Makiko Satomoto

  • 1Department of Anesthesiology, National Defense Medical College, Tokorozawa 359-8513.

Masui. the Japanese Journal of Anesthesiology
|April 3, 2002
PubMed
Summary

Coronary artery spasm during surgery can cause dangerous heart rhythm issues. Promptly recognizing ECG changes may prevent fatal arrhythmias in surgical patients.

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Area of Science:

  • Anesthesiology
  • Cardiology
  • Critical Care Medicine

Background:

  • General anesthesia with isoflurane, nitrous oxide, and fentanyl was administered to a 52-year-old male patient undergoing emergency abdominal surgery for acute abdomen.
  • The patient had no prior history of angina pectoris, indicating no known pre-existing coronary artery disease.

Observation:

  • Despite adequate anesthesia depth, the patient exhibited recurrent electrocardiogram (ECG) abnormalities during the procedure.
  • These ECG changes progressed to a brief run of abnormal heart rhythm.

Findings:

  • Post-anesthesia review of the ECG strongly suggested the occurrence of coronary artery spasm.
  • Coronary artery spasm is a condition where the heart's arteries constrict, reducing blood flow.

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Implications:

  • This case highlights the potential for intraoperative coronary artery spasm in patients without a history of angina.
  • Failure to assess and address ECG abnormalities suggestive of coronary spasm could lead to severe consequences, including fatal arrhythmias.
  • Early detection and management of intraoperative ECG changes are crucial for patient safety during surgery.