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Coronary artery spasm as the probable cause of cardiac arrest immediately after the induction of spinal anesthesia - A case report -
Anesth Pain Med 2018;13(2):180-3
Published online April 30, 2018
© 2018 The Korean Society of Anesthesiologists.

Jung A Kim1, Chan Jong Chung1, Kyoung Sub Yoon1, Jeong In Hong1, Seung Cheol Lee1, Sang Yoong Park1, So Ron Choi1 , Dong Hyun Lee2, and Jin-Heon Jeong2
Departments of 1Anesthesiology and Pain Medicine, 2Intensive Care Medicine, Dong-A University Hospital, Busan, Korea
Correspondence to: So Ron Choi, M.D., Ph.D.
Department of Anesthesiology and Pain Medicine, Dong-A University Hospital, 26 Daesingongwon-ro, Seogu, Busan 49201, Korea
Tel: 82-51-240-5390
Fax: 82-51-247-7819
Received August 1, 2017; Revised December 12, 2017; Accepted December 20, 2017.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
A 72-year-old man underwent spinal anesthesia for artificial urinary sphincter placement for urinary incontinence. After the block level was confirmed below T6, 1 g of cefotetan, which had not shown any reaction on skin test, was administered as a prophylactic antibiotic. The patient began complaining of chest discomfort and dyspnea shortly after injection. ST elevation appeared on the electrocardiogram and the patient’s pulse could not be palpated. Accordingly, cardiopulmonary resuscitation was performed for 5 minutes; the patient recovered spontaneous circulation. The patient was diagnosed as experienced coronary artery spasm by coronary angiography with spasm test. Because coronary artery spasm can also develop in patients with no history of coronary artery disease and under spinal anesthesia, careful observation, suspicion of coronary artery spasm and prompt response to hemodynamic and electrocardiogram changes are necessary.
Key Words : Conduction anesthesia, Coronary vasospasm, Heart arrest, Spinal anesthesia.

April 2018, 13 (2)
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