A Case of Coronary Vasospasm during Neck Surgery

ABSTRACT

Prinzmetal, or variant, angina is an unusual syndrome of cardiac pain, which is secondary to myocardial ischemia resulting from transient increases in coronary vasomotor tone or vasospasm. We experienced a 58-year-old male patient with an unusual ST segment using carotid sinus massage during neck surgery. A coronary angiography, with intravenous ergonovine provocation, showed a reversible coronary artery spasm with typical chest pain and ST segment elevation. This is a report of coronary vasospasm detected during neck surgery, and suggests the role of a dynamic sequential change in autonomic function as a key player in the mechanism behind coronary vasospasm.