Key result
Intravenous nitroglycerin was effective in treating an episode of coronary artery spasm during general anaesthesia, though the episode occurred despite an infusion of 0.25 μg/kg min.
Case Report (n=1)
This case highlights the importance of multi-lead ECG monitoring for detecting perioperative coronary artery spasm and demonstrates the efficacy of intravenous nitroglycerin for its treatment.
Supports multi-lead ECG monitoring for perioperative spasm detection; leaves open prospective evaluation of nitroglycerin prophylaxis.
A case of coronary artery spasm during a non-cardiac surgical procedure is presented. Two paroxysmal episodes of ST segment elevation in lead 11 and aVF without changes in V5 developed during general anaesthesia. These changes were not preceded by increases in heart rate or arterial pressure. The second episode was associated with a ventricular bigeminal rhythm. This case demonstrates the importance of monitoring several leads in patients likely to develop per operative spasm of the coronary arteries. Intravenous nitroglycerin was effective in treating the second episode of coronary artery spasm. However, this episode occurred in spite of nitroglycerin administered intravenously at a rate of 0.25 μg/kg min.
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Briard et al. (1983) conducted a case report in Coronary artery spasm during non-cardiac surgical procedure (n=1). Intravenous nitroglycerin was evaluated on Resolution of coronary artery spasm. Intravenous nitroglycerin was effective in treating an episode of coronary artery spasm during general anaesthesia, though the episode occurred despite an infusion of 0.25 μg/kg min.
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