The Annals of Thoracic Surgery, Vol 36, 97-100, Copyright © 1983 by The Society of Thoracic Surgeons
Intraoperative coronary artery spasm successfully treated with nitroglycerin and nifedipine
DJ Cohen, RW Foley and JM Ryan
Coronary artery spasm is recognized as a major cause of angina and may
coexist with fixed coronary artery disease. This report presents the case
of a patient who developed recurrent coronary artery spasm in the operating
room following effective coronary artery bypass grafting. The coronary
artery spasm was manifested by sudden ST segment elevation, hypotension,
and decreased cardiac output. Direct injection of nitroglycerin into each
coronary artery graft was necessary to reverse the coronary artery spasm.
Peripheral intravenous nitroglycerin plus nifedipine administered through a
nasogastric tube prevented further recurrence of coronary artery spasm.