title: Severe coronary artery spasm induced by epidural injection of bupivacaine hydrochloride: a case report.
abstract: This report describes a case of variant angina induced by epidural infusion of bupivacaine hydrochloride for the treatment of intractable low back pain in a 66-year-old male patient with lumbar discopathy. Severe reversible coronary artery spasm of right coronary artery was demonstrated by coronary angiography. Withdrawal of epidural anesthesia and treatment with nitrates and calcium channel antagonists resulted in cessation of variant angina.
authors.affiliation: Rambam Health Care Campus, Haifa, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Mutlak
authors.forename: Eugenia
authors.initials: E
authors.lastname: Nikolsky
mesh_terms: D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D000788:Angina Pectoris, Variant / Q000139:chemically induced / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000139:chemically induced / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D007268:Injections, Epidural; D017116:Low Back Pain / Q000188:drug therapy*; D008297:Male
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine