Key result
Intravenous nitroglycerin was effective in treating coronary artery spasm during general anesthesia, although the episode occurred despite an ongoing infusion of 0.25 microgram/kg min.
Case Report (n=1)
This case highlights the importance of multi-lead ECG monitoring during non-cardiac surgery to detect coronary artery spasm, which can be effectively treated with intravenous nitroglycerin.
May support IV nitroglycerin for intraoperative spasm; leaves open optimal dosing and ECG monitoring needs.
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 peroperative 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 microgram/kg min.
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Briard et al. (1983) conducted a case report in Coronary artery spasm (n=1). Intravenous nitroglycerin was evaluated on Resolution of coronary artery spasm. Intravenous nitroglycerin was effective in treating coronary artery spasm during general anesthesia, although the episode occurred despite an ongoing infusion of 0.25 microgram/kg min.
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