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[A case of sinus arrest during a surgical operation]
Y Kawaguchi1, T Ohmata, T Kinoshita
1Department of Anesthesiology, Wakayama Red Cross Hospital.
Masui. the Japanese Journal of Anesthesiology
|April 1, 1991
Summary
A 75-year-old woman developed severe bradycardia and asystole during surgery, later diagnosed with sick sinus syndrome despite no prior symptoms. This case highlights the importance of recognizing potential cardiac issues in asymptomatic patients.
Area of Science:
- Cardiology
- Anesthesiology
- Oncology
Background:
- A 75-year-old obese female underwent mastectomy for breast cancer.
- Preoperative ECG revealed premature atrial contractions, but no symptoms of sick sinus syndrome were present.
- The patient was classified as ASA risk II and underwent neuroleptanesthesia.
Observation:
- During surgery, the patient experienced severe bradycardia and a 7-second asystole.
- Initial treatment with atropine sulfate was ineffective.
- Cardiac rhythm spontaneously resumed, and the patient recovered without neurological deficits.
Findings:
- Postoperative 24-hour Holter ECG monitoring revealed significant bradycardia and sinus arrest.
- The patient was definitively diagnosed with sick sinus syndrome.
Implications:
- This case underscores the potential for sudden cardiac events in patients with undiagnosed sick sinus syndrome.
- It emphasizes the need for thorough cardiac evaluation, even in the absence of overt symptoms.
- Anesthesiologists and surgeons should be vigilant for intraoperative arrhythmias in at-risk patients.