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.

Accesso banca dati bibliografica

PMID : 38740184

DOI : 10.1016/j.ipej.2024.05.005

Keywords

Complete atrio-ventricular block; Pacemaker; Vasospastic angina;