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[Coronary artery spasm during neurosurgical anesthesia]
Kaori Harada1, Yuko Nogami, Yasuhiro Morimoto
1Department of Anesthesiology, Ube Industries Central Hospital, Ube 755-0151.
Masui. the Japanese Journal of Anesthesiology
|November 25, 2011
Summary
Coronary artery spasm can occur during neurosurgery even without prior heart disease. Vagal stimulation from surgical manipulation may trigger this event, necessitating careful anesthetic management.
Area of Science:
- Cardiology
- Neurosurgery
- Anesthesiology
Background:
- Coronary artery spasm is a potential complication during surgical procedures.
- Patients undergoing neurosurgery may be at risk, even without a history of ischemic heart disease.
Observation:
- A 69-year-old male patient developed ST elevation and ventricular fibrillation during craniotomy for a meningioma.
- The patient had a history of smoking but no known ischemic heart disease.
Findings:
- Immediate coronary angiography revealed normal coronary arteries, confirming coronary artery spasm as the cause of the electrocardiogram changes.
- Vagal stimulation from surgical manipulation was identified as the likely trigger for the coronary artery spasm.
Implications:
- This case highlights the importance of vigilant anesthetic management to prevent intraoperative coronary artery spasm.
- Proactive measures are crucial for patients undergoing neurosurgery, particularly those without pre-existing cardiovascular conditions.
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