Coronary artery spasm during anesthesia for liver resection

Area of Science:

• Cardiology
• Hepatobiliary Surgery
• Anesthesiology

Background:

• Intraoperative coronary artery spasm (CAS) is an uncommon event, predominantly documented during cardiac surgical procedures.
• CAS can lead to severe hemodynamic compromise and myocardial ischemia.

Observation:

• A case report detailing a patient undergoing liver resection who developed intraoperative coronary artery spasm (CAS).
• The patient exhibited significant ST-segment elevation on electrocardiogram (ECG) leads II and V5, alongside profound hemodynamic instability.

Findings:

• The intraoperative coronary artery spasm (CAS) was effectively managed with intravenous nitroglycerin.
• Postoperative coronary angiography confirmed CAS without significant underlying coronary artery disease, validating the clinical diagnosis.

Implications:

• This case highlights the possibility of CAS occurring outside of cardiac surgery, specifically during non-cardiac procedures like liver resection.
• Early recognition and prompt treatment with vasodilators are crucial for managing CAS and preventing adverse cardiac events.
• Further research may be warranted to understand the specific triggers and risk factors for CAS in non-cardiac surgical settings.