Coronary artery spasm and non-Q-wave myocardial infarction following intravenous ephedrine in two healthy women under spinal anaesthesia.
Vasovagal episodes occur frequently in young healthy patients undergoing venous cannulation and loco-regional anaesthesia. We report two cases of severe coronary vasospasm and non-Q-wave infarction in healthy young women after administration of ephedrine for vasovagal symptoms at the onset of spinal anaesthesia. In the light of unopposed vagal predominance pre-disposing patients to coronary vasospasm, even in young healthy patients, atrophine and not ephedrine should be the first line treatment for bradycardia with or without hypotension under spinal anaesthesia.
Wahl
A
A
Swiss Cardiovascular Centre, University Hospital of Bern, CH-3010 Bern, Switzerland.
Eberli
F R
FR
Thomson
D A
DA
Luginbühl
M
M
D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000503:physiopathology; D004809:Ephedrine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007431:Intraoperative Complications / Q000139:chemically induced*; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000503:physiopathology
D004809:Ephedrine