title: Cardiopulmonary arrest caused by coronary spasm after coronary vasodilator withdrawal during the peri-operative period of gastrectomy.
abstract: Calcium antagonists, nicorandil and long-acting nitrates are highly effective for preventing coronary spasm. The withdrawal of coronary vasodilators, especially calcium antagonists, is risky in cases of vasospastic angina. We herein present a case of cardiopulmonary arrest that occurred due to coronary spasm triggered by the discontinuation of coronary vasodilators during the peri-operative period of gastrectomy. Vasospastic angina patients who are not able to take oral coronary vasodilators in the peri-operative period should be maintained on a parenteral vasodilator until they are able to take them orally. Physicians should also be aware of the possible development of nitrate tolerance in patients on prolonged nitrate therapy.
authors.affiliation: Division of Cardiology, Yokohama City Minato Red Cross Hospital, Japan. kurabayashi.card@yokohama.jrc.or.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Kurabayashi
authors.forename: Kaoru
authors.initials: K
authors.lastname: Okishige
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Asano
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Shimura
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Iwai
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Kato
authors.forename: Kensuke
authors.initials: K
authors.lastname: Ihara
authors.forename: Hideshi
authors.initials: H
authors.lastname: Aoyagi
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Isobe
mesh_terms: D000368:Aged; D000788:Angina Pectoris, Variant / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D003329:Coronary Vasospasm / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004562:Electrocardiography; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*; D028761:Withholding Treatment
chemical_list: D014665:Vasodilator Agents