Reversible Coronary Spasm Induced by Marcaine Mimicking Non-ST Segment Elevation Myocardial Infarction in a Young Patient: A Case Report
Published: 2022-05-25
Page: 200-205
Issue: 2022 - Volume 5 [Issue 1]
M. Njie *
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco.
A. El Jazouli
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco.
P. M Mulendelé
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco.
M Charfo
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco.
M. Haboub
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
A. Salim
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
Med G. Benouna
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
A. Drighil
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
L. Azzouzi
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
R. Habbal
Department of Cardiology, P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Bupivacaine (marcaine) is a long-acting local anesthetic used for skin infiltration, peripheral nerve blocks, epidural and spinal anesthesia. Its application can lead to cardiovascular complications such as: hypotension, bradycardia, cardiac arrest and toxic myocardial injury. Few cases of coronary artery spasm induced by bupivacaine mimicking myocardial infection have been reported in the literature. We report a case of a reversible coronary spasm induced by marcaine during spinal anesthesia confirmed by a provocative vasoactive test on coronary angiography in a 38-year young patient without a known cardiovascular disease admitted initially for scheduled fissurectomy and hemorrhoidectomy in whom treatment by calcium channel blockers reversed patient’s symptoms and electrophysiology signs.
Keywords: Spinal anesthesia, coronary spasm, myocardial infarction