title: [Coronary artery spasm induced by neuroleptic malignant syndrome during off-pump coronary artery bypass grafting; report of a case].
abstract: A 61-year-old woman with a left main lesion and coronary spastic angina was scheduled for off-pump coronary artery bypass grafting (OPCAB). She had been orally receiving selective serotonin reuptake inhibitor( SSRI) for the treatment of depression. OPCAB to left anterior discending artery( LAD) and left circumflex branch (LCX) was performed using the bilateral internal thoracic arteries assisted by intra-aortic balloon pumping. When the sternotomy was going to be closed, ST elevation of electrocardiogram (ECG) occurred and was followed by complete atrio-ventricular (AV) block. After returning to intensive care unit (ICU), the patient showed rapid elevation of the body temperature, excessive sweating, progressive metabolic acidosis, and abnormal high levels in white blood cell count and creatine phosphokinase. On suspicion of neuroleptic malignant syndrome(NMS) onset, dantrolene sodium hydrate was administered, resulting in marked improvement of the symptoms. We have concluded that this case was an NMS combined with coronary artery spasm during OPCAB treated successfully with dantrolene sodium hydrate.
authors.affiliation: Department of Cardiovascular Surgery, Sendai Open Hospital, Sendai, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Mori
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamaya
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Nitta
authors.forename: Seijiro
authors.initials: S
authors.lastname: Yoshida
mesh_terms: D047549:Coronary Artery Bypass, Off-Pump; D003329:Coronary Vasospasm / Q000209:etiology*; D003620:Dantrolene / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D009459:Neuroleptic Malignant Syndrome / Q000150:complications*
chemical_list: D009125:Muscle Relaxants, Central; D003620:Dantrolene