Sudden Cardiac Arrest during Cervical Spine Fusion Surgery Due to Severe Coronary Artery Spasm
Background: Coronary vasospasm can lead to myocardial ischemia and can cause significant hemodynamic instability, arrhythmia,
and cardiac arrest intraoperatively. Coronary artery disease can be overlooked especially in cases in which pre-operative cardiac
investigations are within normal limits. Coronary vasospasm can occur even among patients without a prior history of angina, and
surgery or anesthesia itself may be strong triggers for vasospasm. Cigarette smoking can cause silent ischemic disturbances of
coronary flow mediated by vasoconstriction. Early recognition can allow institution of timely and life-saving intervention.
Case Presentation: A rare case of cardiac arrest due to coronary vasospasm during general anesthesia in a patient undergoing
non-cardiac surgery with no pre-existing cardiac comorbidities is presented.
Conclusion: Coronary artery spasm can occur even among patients without significant cardiac comorbidities.Smoking can lead to
significant disturbances in coronary blood flow.Early recognition and timely intervention can allow institution of life saving intervention.