Key result
Spinal anesthesia triggers transient stress-induced cardiomyopathy and acute hypotension in a healthy patient.
Why the study?
Stress induced cardiomyopathy is a rare complication that can occur perioperatively, but its occurrence following spinal anesthesia for hemorrhoidectomy is not well documented.
Case Report (n=1)
No
Spinal anesthesia may rarely trigger stress cardiomyopathy even in healthy patients; leaves open incidence, causality, and need for prospective data.
A 48-year-old healthy woman was admitted in our hospital for elective hemorrhoidectomy. She developed sudden headache and chest pain, and showed sinus bradycardia, arrhythmia and hypotension forty minutes after spinal anesthesia with 0.5% hyperbaric bupivacaine. An EKG showed ST depression and an transthoracic echocardiogram performed in PACU demonstrated mild LV dysfunction with hypokinesia of LV inferolateral wall. An coronary angiography on postoperative day 1 revealed normal coronary vessel and akinesia of LV inferior wall. Levels of CK-MB and Troponin I were mildly elevated. With medical therapy, the patient's symptoms improved and recovered without any complication.
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Choi et al. (2009) conducted a case report in Stress-induced cardiomyopathy (n=1). Spinal anesthesia with 0.5% hyperbaric bupivacaine was evaluated on Development of stress-induced cardiomyopathy symptoms (chest pain, hypotension, ST depression, LV dysfunction). A 48-year-old healthy woman developed sudden headache, chest pain, and hypotension with transient left ventricular dysfunction indicative of suspected stress-induced cardiomyopathy shortly after spinal anesthesia.
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