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Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
Coronary vasospasm during anesthesia induction: awareness, recognition, possible mechanisms, anesthetic factors, and
Avner Sidi1, Leif Dahleen, Achille Gaspardone
1Department of Anesthesiology, Sheba Medical Center, Tel-Hashomer 52621, Israel.
Abstract:
We describe a patient who developed severe ST-segment elevation, pulseless ventricular tachycardia, and cardiac arrest during induction of general anesthesia. This transient ST-segment elevation may have been the result of coronary artery spasm. Awareness of this variant of coronary artery vasospasm--Prinzmetal angina--in patients without clear symptoms or established ischemic heart disease, is the key to successful outcome. Recommended preparations and treatments are preoperative calcium channel blockers, nitroglycerin available intraoperatively, reduction of endogenous or exogenous catecholamines, and vigilant monitoring.
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