Early diffuse coronary artery spasm after heart valve surgery in the carcinoid syndrome

J Card Surg. 2013 Jul;28(4):402-3. doi: 10.1111/jocs.12138. Epub 2013 May 27.

Abstract

Background: Coronary spasm has been described in the context of carcinoid heart disease, but few information are available over perioperative coronary spasm.

Methods: We describe the case of a patient developing severe spasm of the entire coronary tree immediately after tricuspid valve surgery for carcinoid heart disease, leading to severe myocardial failure.

Results: The spasm was diagnosed by coronary angiography and resolved by intracoronary injection of trinitrine. We present the angiographic features of simultaneous spasm of all coronary arteries and of its evolution.

Conclusion: The present case illustrates the likelihood of perioperative spasm of the entire coronary tree in carcinoid heart disease, and the usefulness of coronary angiography for both diagnosis and treatment.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoid Heart Disease / complications
  • Carcinoid Heart Disease / surgery*
  • Coronary Angiography
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / drug therapy
  • Heart Failure / etiology
  • Humans
  • Injections, Intra-Arterial
  • Male
  • Nitroglycerin / administration & dosage
  • Postoperative Complications* / diagnostic imaging
  • Severity of Illness Index
  • Spasm* / diagnostic imaging
  • Spasm* / drug therapy
  • Time Factors
  • Tricuspid Valve / surgery*
  • Vasodilator Agents / administration & dosage

Substances

  • Vasodilator Agents
  • Nitroglycerin