Refractory coronary vasospasm complicated by complete atrio-ventricular block during neck surgery: is there an indication for pacing? in Indian pacing and electrophysiology journal / Indian Pacing Electrophysiol J. 2024 Jul-Aug;24(4):217-220. doi: 10.1016/j.ipej.2024.05.005. Epub 20
2024
ASL Novara
Tipo pubblicazione
Journal Article
Autori/Collaboratori (4)Vedi tutti...
Facchini E
Division of Cardiology, SS Trinita' Borgomanero Hospital, ASL NO, Novara, Italy.
Maffè S
Division of Cardiology, SS Trinita' Borgomanero Hospital, ASL NO, Novara, Italy. Electronic address: stemaffe@libero.it.
Paffoni P
Division of Cardiology, SS Trinita' Borgomanero Hospital, ASL NO, Novara, Italy.
et alii...
Abstract
Vasospastic angina is a clinical condition characterized by coronary artery spasm in angiographically normal coronary arteries. Vasospastic angina can often lead to ventricular arrhythmias, sudden cardiac death, or life-threatening bradyarrhythmias, such as high-degree atrioventricular block or asystole. We present the unusual case of a woman with depressive syndrome who underwent emergency surgery for hemostasis of a neck lesion that caused hemorrhagic shock after a suicide attempt. During surgery, the electrocardiogram revealed inferior and posterior ST-segment elevation, total atrioventricular block and torsades de pointes; the patient also suffered 4 minutes of cardiac arrest. A temporary pacemaker was placed. Coronary angiography showed right coronary artery vasospasm. Following a second similar episode after tracheostomy, a permanent pacemaker was implanted. The indication for definitive electrostimulation in such a context and the stimulation mechanisms of the carotid sinus underlying vasospasm constitute the interesting points of this clinical case. LEARNING OBJECTIVE: The indication for definitive electrostimulation in a context of recurrent episodes of high-degree atrioventricular block during vasospastic angina and the stimulation mechanisms of the carotid sinus underlying vasospasm constitute the interesting points of this clinical case.
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PMID : 38740184
DOI : 10.1016/j.ipej.2024.05.005
Keywords
Complete atrio-ventricular block; Pacemaker; Vasospastic angina;