Recurrent ST-segment elevations in a patient without significant coronary disease.

Abstract

We report a case of recurrent ST-segment elevations totaling 7 times over 3 hours during subtotal gastrectomy and the early postoperative period in a patient with no history of coronary artery disease. Possible contributing factors include cold stimulus, epidural anesthesia, and inadequate depth of anesthesia. The first episode almost resulted in cardiac arrest and was treated with intravenous epinephrine. The second episode was associated with ventricular fibrillation, which was treated with defibrillation and intravenous verapamil. The third to the seventh episodes were successfully treated with intravenous nitrate. The electrocardiographic changes and postoperative coronary angiography were consistent with a clinical diagnosis of coronary artery spasm. This case suggests that coronary artery spasm is capable of occurring repeatedly in a cyclic pattern during perioperative periods.

• Authors: Ryoji Iida, Seiji Yazaki, Shigeru Saeki, Setsuro Ogawa
• Journal: Journal of clinical anesthesia (J Clin Anesth) Vol. 17 Issue 5 Pg. 372-8 (Aug 2005) ISSN: 0952-8180 [Print] United States
• PMID: 16102690 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Coronary Vasospasm (physiopathology)
• Electrocardiography
• Gastrectomy
• Humans
• Male
• Postoperative Complications (physiopathology)
• Recurrence