Coronary artery spasm induced by carotid sinus stimulation during neck surgery

S. S. Choi; Y. J. Lim; J. H. Bahk; S. H. Do; B. M. Ham

doi:10.1093/bja/aeg051

Coronary artery spasm induced by carotid sinus stimulation during neck surgery

S. S. Choi, Y. J. Lim, J. H. Bahk, S. H. Do, B. M. Ham

Research output: Contribution to journal › Article › peer-review

20 Citations (Scopus)

Abstract

We observed four transient episodes of marked ST-segment elevation in a 58-yr-old man with no history of coronary artery disease undergoing resection of a metastatic neck mass under general anaesthesia. Elevations of the ST segment were abrupt, with no change in arterial pressure or heart rate, and resolved spontaneously. When the carotid sinus was compressed directly, ST-segment elevation was noted 1 min after the onset of stimulation. After surgery, coronary angiography showed diffuse, slight narrowing of the distal bed of the posterolateral branch of the right coronary artery. Ergonovine caused total occlusion of the posterolateral branch of the right coronary artery with chest pain and ST-segment elevation, confirming the diagnosis of variant angina. The coronary artery spasm seems to have been provoked by vagal activation from carotid sinus stimulation during general anaesthesia.

Original language	English
Pages (from-to)	391-394
Number of pages	4
Journal	British Journal of Anaesthesia
Volume	90
Issue number	3
DOIs	https://doi.org/10.1093/bja/aeg051
Publication status	Published - 2003 Mar 1
Externally published	Yes

Keywords

Anaesthesia, general
Complications, coronary vasospasm
Surgery, cardiovascular

ASJC Scopus subject areas

Anesthesiology and Pain Medicine

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10.1093/bja/aeg051

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abstract = "We observed four transient episodes of marked ST-segment elevation in a 58-yr-old man with no history of coronary artery disease undergoing resection of a metastatic neck mass under general anaesthesia. Elevations of the ST segment were abrupt, with no change in arterial pressure or heart rate, and resolved spontaneously. When the carotid sinus was compressed directly, ST-segment elevation was noted 1 min after the onset of stimulation. After surgery, coronary angiography showed diffuse, slight narrowing of the distal bed of the posterolateral branch of the right coronary artery. Ergonovine caused total occlusion of the posterolateral branch of the right coronary artery with chest pain and ST-segment elevation, confirming the diagnosis of variant angina. The coronary artery spasm seems to have been provoked by vagal activation from carotid sinus stimulation during general anaesthesia.",

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T1 - Coronary artery spasm induced by carotid sinus stimulation during neck surgery

AU - Choi, S. S.

AU - Lim, Y. J.

AU - Bahk, J. H.

AU - Do, S. H.

AU - Ham, B. M.

PY - 2003/3/1

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N2 - We observed four transient episodes of marked ST-segment elevation in a 58-yr-old man with no history of coronary artery disease undergoing resection of a metastatic neck mass under general anaesthesia. Elevations of the ST segment were abrupt, with no change in arterial pressure or heart rate, and resolved spontaneously. When the carotid sinus was compressed directly, ST-segment elevation was noted 1 min after the onset of stimulation. After surgery, coronary angiography showed diffuse, slight narrowing of the distal bed of the posterolateral branch of the right coronary artery. Ergonovine caused total occlusion of the posterolateral branch of the right coronary artery with chest pain and ST-segment elevation, confirming the diagnosis of variant angina. The coronary artery spasm seems to have been provoked by vagal activation from carotid sinus stimulation during general anaesthesia.

AB - We observed four transient episodes of marked ST-segment elevation in a 58-yr-old man with no history of coronary artery disease undergoing resection of a metastatic neck mass under general anaesthesia. Elevations of the ST segment were abrupt, with no change in arterial pressure or heart rate, and resolved spontaneously. When the carotid sinus was compressed directly, ST-segment elevation was noted 1 min after the onset of stimulation. After surgery, coronary angiography showed diffuse, slight narrowing of the distal bed of the posterolateral branch of the right coronary artery. Ergonovine caused total occlusion of the posterolateral branch of the right coronary artery with chest pain and ST-segment elevation, confirming the diagnosis of variant angina. The coronary artery spasm seems to have been provoked by vagal activation from carotid sinus stimulation during general anaesthesia.

KW - Anaesthesia, general

KW - Complications, coronary vasospasm

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Coronary artery spasm induced by carotid sinus stimulation during neck surgery

Abstract

Keywords

ASJC Scopus subject areas

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