Related Experiment Videos
[Coronary artery spasm after mitral valve replacement: a case report]
1Department of Cardiovascular Surgery, Honda Memorial Hospital, Koriyama, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|April 1, 1994
Summary
Coronary artery spasm can cause sudden circulatory collapse after heart surgery, even without prior heart disease. Prompt diltiazem infusion can help manage this critical condition.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- A 50-year-old female patient underwent reoperation for a malfunctioning bioprosthetic mitral valve.
- Preoperative coronary arteriograms were normal, and the patient had no history of angina pectoris or use of related medications.
Observation:
- Two hours post-reoperation, the patient experienced abrupt ST segment elevation on EKG, leading to ventricular tachycardias and fibrillations.
- This life-threatening circulatory collapse persisted until diltiazem infusion was initiated.
Findings:
- Postoperative coronary arteriography revealed spasm in the proximal right coronary artery segment.
- Maximum CPK-MB levels reached 145 IU/l, indicating myocardial injury.
Implications:
- Coronary artery spasm is a critical consideration for unexpected circulatory collapse following open-heart surgery.
- This condition can occur even in patients without pre-existing coronary artery disease.