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[Coronary spasm during repeated anesthesia].

O Corre, A Legrand, M Riou

    Annales Francaises D'Anesthesie Et De Reanimation
    |January 1, 1984
    PubMed
    Summary
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    Coronary arterial spasm can occur during anesthesia after aorto-femoral bypass grafting, leading to arrhythmias. Prevention and treatment involve avoiding certain conditions and using calcium antagonists or nitroglycerin.

    Area of Science:

    • Cardiology
    • Anesthesiology
    • Vascular Surgery

    Background:

    • Aorto-femoral bypass grafting is a significant vascular surgery procedure.
    • Coronary arterial spasm is a potential complication during anesthesia.
    • Ventricular arrhythmias can accompany coronary spasm.

    Observation:

    • Coronary arterial spasm was observed during two separate anesthesia procedures in a patient post-aorto-femoral bypass.
    • The spasm episodes were associated with transient but serious ventricular arrhythmias.
    • These arrhythmias resolved without lasting effects.

    Findings:

    • Clinical and electrocardiographic features of peroperative coronary arterial spasm were identified.
    • Factors like peroperative alkalosis, hypothermia, and parasympathetic stimuli may trigger spasm in susceptible patients.

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  • Calcium antagonists demonstrated preventive efficacy, while intravenous nitroglycerin proved effective for acute treatment.
  • Implications:

    • Awareness of peroperative coronary arterial spasm is crucial in patients with a history of vascular grafting.
    • Management strategies should focus on avoiding precipitating factors during anesthesia.
    • Pharmacological interventions, including calcium antagonists and nitroglycerin, are vital for managing this complication.