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[Intraoperative coronary spasm in non-cardiac surgery]
Kyung-ho Chang1, Kazuo Hanaoka
1Department of Anesthesiology, Faculty of Medicine, University of Tokyo, Tokyo 113-8655.
Masui. the Japanese Journal of Anesthesiology
|February 19, 2004
Summary
Intraoperative coronary spasm can occur even without chest pain history. Prompt use of coronary dilators, like nitrates, effectively treats spasm and improves patient outcomes during non-cardiac surgery.
Area of Science:
- Anesthesiology
- Cardiology
- Critical Care Medicine
Context:
- Perioperative cardiovascular events pose significant risks.
- Intraoperative coronary spasm is a critical complication during non-cardiac surgery.
- Understanding its characteristics is vital for patient safety.
Purpose:
- To review and analyze the clinical features, treatments, and outcomes of intraoperative coronary spasm.
- To identify key contributing factors and effective interventions.
Summary:
- A review of 56 patients experiencing intraoperative coronary spasm during non-cardiac surgery.
- Common factors include regional anesthesia, vasopressors, alkalosis, hypotension, and vagal stimulation.
- Nitrates and other coronary dilators proved highly effective in treatment.
Impact:
- Highlights that coronary spasm can occur in patients without prior chest pain.
- Emphasizes that intraoperative conditions can trigger vasoconstriction.
- Recommends immediate administration of coronary dilators upon spasm occurrence.