Postoperative diffuse coronary spasm after two valve surgery - a rare phenomenon

Postoperative coronary artery spasm is one of the grave complications of cardiac surgery and is usually seen in patients undergoing coronary artery bypass surgery. We describe the case of a 63 year old male patient developing postoperative spasm of the entire coronary tree after aortic & mitral valve replacement, manifesting as significant electrocardiographic changes. Urgent coronary angiography was performed which revealed diffuse spasm of the entire coronary tree. It resolved completely with intracoronary injection of Nitroglycerine. The present case highlights the likelihood of postoperative coronary spasm even after valve replacement surgery, and not just coronary bypass surgery. It also illustrated the usefulness of coronary angiography for both diagnosis and treatment of this entity.