A 72-year-old man underwent
spinal anesthesia for
artificial urinary sphincter placement for
urinary incontinence. After the block level was confirmed below T6, 1 g of
cefotetan, which had not shown any reaction on
skin test, was administered as a prophylactic
antibiotic. The
patient began complaining of
chest discomfort and
dyspnea shortly after
injection. ST elevation appeared on the
electrocardiogram and the
patient's
pulse could not be palpated. Accordingly,
cardiopulmonary resuscitation was performed for 5 minutes; the
patient recovered spontaneous circulation. The
patient was diagnosed as experienced
coronary artery spasm by
coronary angiography with
spasm test. Because
coronary artery spasm can also develop in
patients with no
history of
coronary artery disease and under
spinal anesthesia, careful
observation, suspicion of
coronary artery spasm and prompt response to
hemodynamic and
electrocardiogram changes are necessary.