[Case of undiagnosed vasospastic angina first noted during anesthesia].
A 75-year-old man patient was scheduled for total gastrectomy, splenectomy, and cholecyctectomy who had been hypertensive. The patient had no symptoms related to cardiac disease before surgery. Preoperative ECG showed only complete right bundle branch block. After arriving in the operating room, epidural anesthesia was performed at the T8-9 inter space and general anesthesia was induced with propofol without difficulty. Before operation, suddenly PVCs appeared, followed by VT and VF. Immediately the patient was treated with defibrillation, nitroglycerin and nicorandil. The operation was canceled. Vasospastic angina was diagnosed by acetylcholine infusion test postoperatively. Most of patients with vasospastic angina show elevation of ST segment on ECG at first, but our case showed VT and VF without ST elevation on ECG.
Hashimoto
Yuichi
Y
Department of Anesthesiology, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya 343-8555.
Matsuda
Yoshifumi
Y
Enomoto
Yoshiro
Y
Inoue
Hisashi
H
Arai
Takero
T
Saitoh
Tomoyuki
T
Kamishima
Keiichiro
K
Okuda
Yasuhisa
Y
D000368:Aged; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000788:Angina Pectoris, Variant / Q000175:diagnosis; D004562:Electrocardiography; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D013274:Stomach Neoplasms / Q000601:surgery; D017180:Tachycardia, Ventricular; D014693:Ventricular Fibrillation