title: Coronary artery spasm and non-Q-wave myocardial infarction following intravenous ephedrine in two healthy women under spinal anaesthesia.
abstract: 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.
authors.affiliation: Swiss Cardiovascular Centre, University Hospital of Bern, CH-3010 Bern, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Wahl
authors.forename: F R
authors.initials: FR
authors.lastname: Eberli
authors.forename: D A
authors.initials: DA
authors.lastname: Thomson
authors.forename: M
authors.initials: M
authors.lastname: Luginbühl
mesh_terms: 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
chemical_list: D004809:Ephedrine