A cardiac arrest: when recommended mild therapeutic hypothermia reveals the mechanism*

Crit Care Med. 2012 Mar;40(3):976-8. doi: 10.1097/CCM.0b013e3182377240.

Abstract

Aim: Describe the interaction between the use of mild induced hypothermia and acute diffuse coronary spasm.

Methods: We report the case of a 52-yr-old Caucasian woman resuscitated after initial cardiac arrest, with normal postresuscitation electrocardiogram, sufficient hemodynamic conditions, and decreased level of consciousness, who received mild induced hypothermia to reduce brain damage as suggested by cardiopulmonary resuscitation guidelines.

Results: After the beginning of mild therapeutic hypothermia, the patient experienced malignant diffuse coronary artery spasm, so-called Prinzmetal's angina, leading to myocardial ischemia and ventricular tachycardia, which was only resolved by intracoronary vasodilator injection.

Conclusion: Mild induced hypothermia was apparently the trigger of a severe and diffuse coronary artery spasm.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Heart Arrest / etiology
  • Heart Arrest / therapy*
  • Humans
  • Hypothermia, Induced*
  • Middle Aged