ST-segment elevation induced by coronary artery spasm during tilt-table test

2013 ◽  
Vol 7 (5) ◽  
pp. 274-275
Author(s):  
Hesham R. Omar ◽  
Fengdan Wang ◽  
James Fairbairn
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Spasm ◽  
Tilt Table Test ◽  
Tilt Table ◽  
St Segment Elevation ◽  
St Segment

scholarly journals Recurrent Coronary Artery Spasm Induced by Vasopressors During Two Operations in the Same Patient Under General Anesthesia

2018 ◽  
Vol 65 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Naotaka Kishimoto ◽  
Munenori Kato ◽  
Yasunori Nakanishi ◽  
Akari Hasegawa ◽  
Yoshihiro Momota
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
General Anesthesia ◽  
Computed Tomography Angiography ◽  
Coronary Artery Spasm ◽  
Variant Angina ◽  
St Segment Elevation ◽  
Know How ◽  
St Segment

Variant angina is caused by coronary artery spasm (CAS) with ST-segment elevation. We herein report a case of recurrent CAS during 2 operations in the same patient. An 80-year-old woman was scheduled to undergo tracheostomy, submandibular dissection, left partial maxillectomy, and coronoidectomy. We administered ephedrine and phenylephrine to manage hypotension during general anesthesia. Immediately after the administration of these drugs, the ST segment elevated. We decided to cease the operation and transport the patient to the department of cardiology. Computed tomography angiography revealed pneumomediastinum. The cardiologists considered that the electrocardiography findings had changed secondary to pneumomediastinum. About 6 weeks later, a second operation was scheduled. We administered ephedrine and phenylephrine to manage hypotension during general anesthesia. Immediately after the administration of these drugs, ST-segment elevation occurred. We discontinued use of these drugs, and the ST-segment elevation did not recur. We considered that the cause of the ST-segment elevation was vasopressor-induced CAS because the vasopressors were administered immediately before the occurrence of CAS. Vasopressors such as ephedrine or phenylephrine are frequently used to manage hypotension during general anesthesia. Therefore, anesthesiologists should consider the occurrence of CAS before using vasopressors and know how to manage CAS well.

scholarly journals Comparison of coronary hemodynamic and cardiac metabolic alterations during coronary artery spasm associated with ST segment elevation or depression.

1985 ◽  
Vol 49 (4) ◽  
pp. 422-431 ◽  
Author(s):  
KAZUHISA KODAMA ◽  
MASAKAZU YAMAGISHI ◽  
SHlNSUKE NANTO ◽  
TSUNEHIKO KUZUYA ◽  
YUKIHIRO KORETSUNE ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Spasm ◽  
Metabolic Alterations ◽  
St Segment Elevation ◽  
St Segment

scholarly journals The Challenges of Treating Acute Myocardial Infarction due to Variant Angina: Lesson from an Interesting Case

2020 ◽  
Author(s):  
Guo-Hua Li
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Spasm ◽  
Interesting Case ◽  
Variant Angina ◽  
St Segment Elevation ◽  
St Segment

Coronary artery spasm can cause recurrent variant angina with ST-segment elevation. The patient was asymptomatic with normal vitals and ECG was normal. We present a case associated with transient ST-segment elevation and significant increase in troponin levels with non-critical lesion with normal CAG

scholarly journals A Case of Spontaneous Multivessel Coronary Artery Spasm That Underwent Stent Implantation Accompanying ST Segment Elevation on Inferior Electrocardiographic Leads

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Nuray Kahraman Ay ◽  
Muharrem Nasifov ◽  
Ömer Goktekin
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Ischaemia ◽  
Coronary Artery Spasm ◽  
Coronary Spasm ◽  
St Segment Elevation ◽  
St Segment ◽  
Coronary Artery Segment ◽  
Artery Segment ◽  
Electrocardiographic Leads

Coronary artery spasm is usually defined as a focal constriction of a coronary artery segment, which is reversible, and causes myocardial ischaemia by restricting coronary blood flow. A coronary spasm may rarely compromise all three epicardial arteries simultaneously. We present a case of severe coronary spasm afflicting all coronary arteries accompanying an ST segment elevation in leads D2-D3 and aVF.

scholarly journals Vasospastic angina pectoris complicated by acute myocardial infarction and complete atrioventricular block

2011 ◽  
Vol 68 (7) ◽  
pp. 611-615
Author(s):  
Milan Pavlovic ◽  
Goran Koracevic ◽  
Snezana Ciric-Zdravkovic ◽  
Nebojsa Krstic ◽  
Aleksandar Stojkovic ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Spasm ◽  
Myocardial Necrosis ◽  
Middle Part ◽  
Cold Weather ◽  
Vasospastic Angina ◽  
St Segment Elevation ◽  
St Segment ◽  
Retrosternal Pain ◽  
Vasospastic Angina Pectoris

Background. A prolonged coronary artery spasm with interruption of coronary blood flow can lead to myocardial necrosis and increase of cardiospecific enzymes and can be complicated with cardiac rhythm disturbances, syncopc, or even sudden cardiac death. Case report. A 55-year old male felt a severe retrosternal pain when exposing himself to cold weather. The pain lasted for 20 minutes and was followed by the loss of conscience. Electrocardiogram (ECG) showed a complete antrioventricular (AV) block with nodal rhythm and marked elevation of ST segment in inferior leads. Electrocardiogram was soon normalized, but serum activities of cardiospecific enzymes were increased. Coronarography showed normal findings for the left coronary artery and a narrowing at the middle part of the right coronary artery, which disappeared after intracoronary application of nitroglycerine. The following therapy was prescribed: Diltiazem, Amlodipin, Isosorbid mononitrate, Molisdomin, Atrovastatin, Aspirin and Nitroglycerine spray. After 7 months medicaments were abandoned and the patient experienced again reccurent chest pain episodes at rest. Transitory ST segment elevation was recorded in inferior leads of ECG, but without increase of cardiospecific enzymes serum activities. After restoration of the medicament therapy anginal episodes ceased. Conclusion. Coronary dilators in maximal doses can prevent attacks of vasospastic angina.

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