title: Early diffuse coronary artery spasm after heart valve surgery in the carcinoid syndrome.
abstract: BACKGROUND
  Coronary spasm has been described in the context of carcinoid heart disease, but few information are available over perioperative coronary spasm.
  
  
  METHODS
  We describe the case of a patient developing severe spasm of the entire coronary tree immediately after tricuspid valve surgery for carcinoid heart disease, leading to severe myocardial failure.
  
  
  RESULTS
  The spasm was diagnosed by coronary angiography and resolved by intracoronary injection of trinitrine. We present the angiographic features of simultaneous spasm of all coronary arteries and of its evolution.
  
  
  CONCLUSIONS
  The present case illustrates the likelihood of perioperative spasm of the entire coronary tree in carcinoid heart disease, and the usefulness of coronary angiography for both diagnosis and treatment.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Anselmi
authors.forename: Hervé
authors.initials: H
authors.lastname: Corbineau
authors.forename: Dominique
authors.initials: D
authors.lastname: Boulmier
authors.forename: Vito Giovanni
authors.initials: VG
authors.lastname: Ruggieri
mesh_terms: D000368:Aged; D002275:Carcinoid Heart Disease / Q000150:complications / Q000601:surgery*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000188:drug therapy; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D005996:Nitroglycerin / Q000008:administration & dosage; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012720:Severity of Illness Index; D013035:Spasm / Q000000981:diagnostic imaging / Q000188:drug therapy; D013997:Time Factors; D014261:Tricuspid Valve / Q000601:surgery*; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin