Recurrent ST segment elevations in a patient with asymptomatic early repolarization during head and neck surgery: implications of vasospastic angina
박세웅, 김성훈, 권혜미, Koh Gi-Ho, 남기병, 감명환, 김욱종, 구승우,
소속 상세정보
박세웅 ( Park Se-Ung ) - University of Ulsan College of Medicine Department of Anesthesiology and Pain Medicine
김성훈 ( Kim Sung-Hoon ) - University of Ulsan College of Medicine Department of Anesthesiology and Pain Medicine
권혜미 ( Kwon Hye-Mee ) - Hanyang University College of Medicine Department of Anesthesiology and Pain Medicine
( Koh Gi-Ho ) - University of Ulsan College of Medicine Department of Anesthesiology and Pain Medicine
남기병 ( Nam Gi-Byoung ) - University of Ulsan College of Medicine Department of Cardiology
감명환 ( Karm Myong-Hwan ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
김욱종 ( Kim Wook-Jong ) - University of Ulsan College of Medicine Department of Anesthesiology and Pain Medicine
구승우 ( Ku Seung-Woo ) - University of Ulsan College of Medicine Department of Anesthesiology and Pain Medicine
Abstract
A 57-year-old woman scheduled for cochlear implant removal exhibited preoperative electrocardiographic findings of early repolarization (ER). Four episodes of transient ST segment elevations during surgery raised suspicion for vasospastic angina (VA). In the post-anesthetic care unit, the patient complained of chest discomfort and received sublingual nitroglycerin with uncertain effect. The patient refused to proceed with postoperative invasive coronary angiography, resulting in inconclusive diagnosis. Intraoperative circumstances limit the diagnosis of VA, which emphasizes the need for further testing to confirm the diagnosis. When VA is suspected in patients with underlying ER, it is reasonable to consider invasive examination to establish the diagnosis and prevent recurrence of VA. If ST changes are observed during surgery in patients with preoperative ER, careful monitoring is recommended. Due to general anesthesia, the absence of patient symptoms limits the definitive diagnosis of those with suspected VA. Therefore, additional postoperative surveillance is recommended.
키워드
Early Repolarization; Recurrent ST Elevation; Vasospastic Angina
원문 및 링크아웃 정보
등재저널 정보