Why the study?
Both Wolff-Parkinson-White syndrome and coronary vasospasm carry risks of fatal arrhythmias, prompting the report of a rare case of cardiac arrest caused by coronary vasospasm during general anesthesia in a patient with pre-existing WPW syndrome.
Highlights the rare occurrence of cardiac arrest due to coronary vasospasm during general anesthesia in a patient with pre-existing WPW syndrome, which can mimic pseudo-VT.
Alerts clinicians to rare vasospasm arrest risk in WPW under anesthesia; leaves open need for targeted protocols.
BACKGROUND: Wolff-Parkinson-White (WPW) syndrome has the risk of sudden cardiac death. Without appropriate treatment, coronary vasospasm is also a potentially fatal condition due to ischemia-induced ventricular fibrillation. A rare case of cardiac arrest due to coronary vasospasm during general anesthesia in a patient with pre-existing WPW syndrome is presented. CASE PRESENTATION: A 55-year-old man was scheduled for brain surgery under general anesthesia. During surgery, the ECG monitor showed ST segment elevation followed by sustained ventricular tachycardia and the patient's blood pressure was unmeasurable. Since pseudo-VT with WPW syndrome was suspected, pilsicainide was administered. A few weeks later, a spasm provocation test with acetylcholine was performed, which showed complete spastic occlusion of the right coronary artery. CONCLUSIONS: A rare case of cardiac arrest during surgery in a patient with WPW syndrome, possibly caused by coronary vasospasm, was described.
No takes yet. Share an insight, caveat, or question.
Matsuki et al. (2019) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: