Usefullness of transesophageal echocardiography in early detection of coronary spasm
Sagara, M.; Haraguchi, M.; Hamu, Y.; Isowaki, S.; Yoshimura, N.
Masui. Japanese Journal of Anesthesiology 45(4): 487-490
1996
ISSN/ISBN: 0021-4892 PMID: 8725608 Document Number: 469278
Intraoperative transesophageal echocardiography (TEE) was performed on a 62-year-old man who underwent abdominal aortic replacement for abdominal aortic aneurysm under general anesthesia combined with epidural anesthesia. Coronary artery spasm occurred after unexpected massive hemorrhage, and TEE showed hypokinesis in the posterior-inferior left ventricular wall. The changes in TEE preceded the ST elevation in the ECG. Bolus infusion of isosorbide dinitrate and continuous infusion of nitroglycerin alleviated these changes. TEE enabled us to detect and evaluate coronary spasm before the appearance of ST changes in ECG.