Key result
Anesthesia induction triggers acute intraventricular conduction defect and severe bradycardia in asymptomatic NSTEMI.
Why the study?
Little is known about asymptomatic intraventricular conduction defects occurring prior to urgent coronary artery bypass grafting after NSTEMI.
Case Report (n=1)
No
Silent conduction defects may emerge at anesthesia induction in asymptomatic NSTEMI; case report extends awareness but leaves open incidence and management implications.
Intraventricular conduction abnormalities have been thoroughly described in the setting of post cardiac surgery in particular after valvular surgery. It’s also widely known that several anaesthetic factors are known to cause autonomic disturbances resulting in unmasking of a sinus node dysfunction, significant bradycardia, and cardiovascular collapse during the intraoperative period. However, little is known on asymptomatic episodes in particular prior to CABG. We report a rare occurrence of intraventricular conduction defect that presented in an asymptomatic patient following NSTEMI and prior to urgent coronary artery revascularization. We aim to highlight the measures that were taken to manage this.
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Mohamad Bashir (2017) conducted a case report in Non-ST elevation myocardial infarction (NSTEMI) and multivessel coronary disease (n=1). Coronary artery bypass grafting (CABG) and permanent pacemaker insertion was evaluated. An asymptomatic patient with NSTEMI and normal preoperative sinus rhythm developed a sudden intraventricular conduction defect causing severe bradycardia during anesthesia induction for urgent CABG.
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