Coronary Artery Spasm during Cholecystectomy with Pneumoperitoneum - A Case Report

Soushi Iwasaki, Shingo Furuse, Masanori Watanabe, Masanori Yamauchi, Makoto Asano, Hitoshi Ooiwa, Michiaki Yamakage, Akiyoshi Namiki

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

A 59-year-old man without a history of ischemic heart disease underwent elective laparoscopic cholescystectomy under general anesthesia with epidural anesthesia. About 15 min after pneumoperitoneum had been achieved, the patient developed ST elevation and hypotension. Vagal stimulation resulting from stretching peritoneum, the procedure and epidural anesthesia are thought to have induced vasospasm. The ST segment became normal after interruption of CO2 insufflation. A postoperative coronary artery angiogram showed normal coronary arteries, but diffuse coronary artery spasm was seen after intracoronary injection of acetylcholine. The patient was discharged on nitrates. Patients with gall bladder stones sometimes have coronary risk factors of obesity, hyperlipidemia and hyperglycemia. Careful attention should also be given to patients who do not have a history of coronary disease.

Original languageEnglish
Pages (from-to)59-62
Number of pages4
JournalJapanese Journal of Anesthesiology
Volume53
Issue number1
Publication statusPublished - 2004 Jan
Externally publishedYes

Keywords

  • Coronary artery spasm
  • Coronary risk factors
  • Laparoscopic pneumoperitoneum
  • Lifestyle-related diseases
  • Parasympathetic nerve

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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