Perioperative cardiac arrest and life-threatening ventricular arrhythmias: A five-patient case series.

Background Perioperative cardiac arrest and life-threatening ventricular arrhythmias are critical anaesthetic emergencies associated with substantial morbidity and mortality. The study describes five cardiovascular emergencies across diverse operative settings, highlighting presentation, resuscitation, early outcomes and potential contributing factors. Case presentations Five patients aged 21–55 years experienced severe perioperative cardiovascular events. A man undergoing open hernioplasty for a strangulated inguinal hernia under spinal anaesthesia developed bradycardia followed by ventricular tachycardia (VT). A woman with Glanzmann thrombasthenia developed haemorrhagic shock and pulseless electrical activity during laparotomy. A patient with severe preeclampsia and anaemia experienced a fatal cardiac event during post-caesarean re-exploration. A man undergoing thoracic spine surgery developed post-induction collapse with subsequently documented VT. A postpartum patient with uterine inversion developed pulseless VT. Cardiopulmonary resuscitation was reported in all five cases. Four patients survived the immediate event; one maternal death occurred. Rhythm and medication documentation varied across cases. Recommendations: Early identification of cardiovascular instability, continuous haemodynamic monitoring, and prompt rhythm-directed resuscitation are essential for improving perioperative outcomes. Preoperative risk assessment, availability of emergency equipment and blood products, effective multidisciplinary coordination, and structured post-resuscitation care are recommended to enhance patient safety. Conclusion Intraoperative cardiac events included cardiac arrest, and all affected patients were successfully resuscitated, highlighting the importance of early recognition, prompt intervention, and effective perioperative resuscitation strategies. Postoperative echocardiography was performed to assess cardiac function, followed by continued clinical monitoring. During follow-up evaluations conducted approximately 4–5 months after surgery, repeat echocardiography demonstrated improvement in cardiac function, particularly left ventricular ejection fraction, which had returned to within normal limits. These findings highlight the importance of timely resuscitation, comprehensive postoperative cardiac assessment, and structured long-term follow-up in evaluating myocardial recovery and favourable cardiovascular outcomes following life-threatening intraoperative cardiac events.