Key result
Spinal anesthesia linked to coronary artery spasm and cardiac arrest in a patient without prior CAD.
Case Report (n=1)
No
This case highlights that coronary artery spasm can rarely occur during spinal anesthesia, leading to life-threatening circulatory collapse and cardiac arrest.
Spinal anesthesia may rarely provoke coronary spasm and arrest even without CAD; leaves open whether heightened vigilance or protocols are warranted.
Variant angina was first described by Prinzmetal et al. [1], and is one of the major causes of intraoperative or perioperative myocardial ischemia.If not treated immediately, it can lead to myocardial infarction and death [2].Coronary artery spasm (CAS) rarely occurs during anesthesia, and occurrences of CAS during spinal anesthesia leading to circulatory collapse are especially rare [3].We report a case involving a patient with no history of coronary artery disease, who experienced cardiac arrest accompanied by ST elevation immediately after induction of spinal anesthesia and administration of prophylactic antibiotic.The patient recovered spontaneous circulation after cardiopulmonary resuscitation (CPR).The patient was eventually diagnosed with CAS based on an-giography results.The only suspicious cause for CAS was hemodynamic change due to spinal anesthesia and emotional stress.
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Kim et al. (2018) conducted a case report in Coronary artery spasm and cardiac arrest (n=1). Spinal anesthesia was evaluated on Cardiac arrest. Spinal anesthesia induced coronary artery spasm and subsequent cardiac arrest in a 72-year-old man with no prior history of coronary artery disease.
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