Key result
Withdrawal of oral coronary vasodilators during the peri-operative period of gastrectomy triggered a life-threatening coronary spasm resulting in cardiopulmonary arrest in a patient with vasospastic angina.
Case Report (n=1)
No
Withdrawal of oral coronary vasodilators, especially calcium antagonists, during the peri-operative period in patients with severe vasospastic angina can trigger life-threatening coronary spasm and cardiopulmonary arrest.
May warrant caution with vasodilator withdrawal in perioperative vasospastic angina; leaves open prospective protocols.
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.
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Kurabayashi et al. (2013) conducted a case report in Vasospastic angina (n=1). Withdrawal of coronary vasodilators was evaluated on Cardiopulmonary arrest. Withdrawal of oral coronary vasodilators during the peri-operative period of gastrectomy triggered a life-threatening coronary spasm resulting in cardiopulmonary arrest in a patient with vasospastic angina.
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