Cardiopulmonary arrest caused by coronary spasm after coronary vasodilator withdrawal during the peri-operative period of gastrectomy

Intern Med. 2013;52(1):81-4. doi: 10.2169/internalmedicine.52.8918. Epub 2013 Jan 1.

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angina Pectoris, Variant / complications
  • Angina Pectoris, Variant / diagnosis
  • Angina Pectoris, Variant / drug therapy*
  • Cardiopulmonary Resuscitation / methods
  • Coronary Vasospasm / complications
  • Coronary Vasospasm / diagnosis
  • Coronary Vasospasm / drug therapy*
  • Electrocardiography
  • Follow-Up Studies
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods
  • Heart Arrest / etiology*
  • Heart Arrest / therapy
  • Humans
  • Male
  • Postoperative Complications / diagnosis
  • Postoperative Complications / drug therapy
  • Risk Assessment
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery
  • Treatment Outcome
  • Vasodilator Agents / administration & dosage*
  • Withholding Treatment*

Substances

  • Vasodilator Agents