Coronary artery spasm induced by carotid sinus stimulation during neck surgery

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

Research output: Contribution to journalArticle

17 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 languageEnglish
Pages (from-to)391-394
Number of pages4
JournalBritish Journal of Anaesthesia
Volume90
Issue number3
DOIs
Publication statusPublished - 2003 Mar 1
Externally publishedYes

Fingerprint

Carotid Sinus
Spasm
Coronary Vessels
Neck
General Anesthesia
Ergonovine
Coronary Angiography
Chest Pain
Coronary Artery Disease
Arterial Pressure
Heart Rate

Keywords

  • Anaesthesia, general
  • Complications, coronary vasospasm
  • Surgery, cardiovascular

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Coronary artery spasm induced by carotid sinus stimulation during neck surgery. / Choi, Sang Sik; Lim, Y. J.; Bahk, J. H.; Do, S. H.; Ham, B. M.

In: British Journal of Anaesthesia, Vol. 90, No. 3, 01.03.2003, p. 391-394.

Research output: Contribution to journalArticle

Choi, Sang Sik ; Lim, Y. J. ; Bahk, J. H. ; Do, S. H. ; Ham, B. M. / Coronary artery spasm induced by carotid sinus stimulation during neck surgery. In: British Journal of Anaesthesia. 2003 ; Vol. 90, No. 3. pp. 391-394.
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