Cardiopulmonary arrest caused by coronary spasm after coronary vasodilator withdrawal during the peri-operative period of gastrectomy.

Abstract

Calcium antagonists, nicorandil and long-acting nitrates are highly effective for preventing coronary spasm. The withdrawal of coronary vasodilators, especially calcium antagonists, is risky in cases of vasospastic angina. We herein present a case of cardiopulmonary arrest that occurred due to coronary spasm triggered by the discontinuation of coronary vasodilators during the peri-operative period of gastrectomy. Vasospastic angina patients who are not able to take oral coronary vasodilators in the peri-operative period should be maintained on a parenteral vasodilator until they are able to take them orally. Physicians should also be aware of the possible development of nitrate tolerance in patients on prolonged nitrate therapy.

• Authors: Manabu Kurabayashi, Kaoru Okishige, Mitsutoshi Asano, Hidetoshi Suzuki, Tsukasa Shimura, Shinsuke Iwai, Nobutaka Kato, Kensuke Ihara, Hideshi Aoyagi, Mitsuaki Isobe
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 52 Issue 1 Pg. 81-4 ( 2013) ISSN: 1349-7235 [Electronic] Japan
• PMID: 23291678 (Publication Type: Case Reports, Journal Article)

Chemical References

• Vasodilator Agents

Topics

• Aged
• Angina Pectoris, Variant (complications, diagnosis, drug therapy)
• Cardiopulmonary Resuscitation (methods)
• Coronary Vasospasm (complications, diagnosis, drug therapy)
• Electrocardiography
• Follow-Up Studies
• Gastrectomy (adverse effects, methods)
• Heart Arrest (etiology, therapy)
• Humans
• Male
• Postoperative Complications (diagnosis, drug therapy)
• Risk Assessment
• Stomach Neoplasms (pathology, surgery)
• Treatment Outcome
• Vasodilator Agents (administration & dosage)
• Withholding Treatment