脑外科手术期间 Wolff-Parkinson-White 综合征患者因冠状动脉痉挛导致的心搏骤停：一例报告
Sudden cardiac arrest due to coronary vasospasm in a patient with Wolff-Parkinson-White syndrome during brain surgery: a case report.
作者信息
Matsuki Yuka, Mizogami Maki, Shigemi Kenji
机构信息
Department of Anesthesiology and Reanimatology, Faculty of Medicine Sciences, University of Fukui, 23-3 Eiheijicho, Yoshidagun, Fukui, 910-1193, Japan.
出版信息
JA Clin Rep. 2019 Feb 28;5(1):13. doi: 10.1186/s40981-019-0233-2.
BACKGROUND
Wolff-Parkinson-White (WPW) syndrome has the risk of sudden cardiac death. Without appropriate treatment, coronary vasospasm is also a potentially fatal condition due to ischemia-induced ventricular fibrillation. A rare case of cardiac arrest due to coronary vasospasm during general anesthesia in a patient with pre-existing WPW syndrome is presented.
CASE PRESENTATION
A 55-year-old man was scheduled for brain surgery under general anesthesia. During surgery, the ECG monitor showed ST segment elevation followed by sustained ventricular tachycardia and the patient's blood pressure was unmeasurable. Since pseudo-VT with WPW syndrome was suspected, pilsicainide was administered. A few weeks later, a spasm provocation test with acetylcholine was performed, which showed complete spastic occlusion of the right coronary artery.
CONCLUSIONS
A rare case of cardiac arrest during surgery in a patient with WPW syndrome, possibly caused by coronary vasospasm, was described.
背景
预激综合征（WPW）有心脏性猝死的风险。未经适当治疗，冠状动脉痉挛因缺血诱发心室颤动也是一种潜在的致命状况。本文报告了一例患有预激综合征的患者在全身麻醉期间因冠状动脉痉挛导致心脏骤停的罕见病例。
病例介绍
一名55岁男性计划在全身麻醉下进行脑部手术。手术期间，心电图监测显示ST段抬高，随后出现持续性室性心动过速，患者血压无法测量。由于怀疑是预激综合征引起的假性室性心动过速，给予了吡西卡尼。几周后，进行了乙酰胆碱激发试验，结果显示右冠状动脉完全痉挛性闭塞。
结论
描述了一例预激综合征患者在手术期间因冠状动脉痉挛可能导致心脏骤停的罕见病例。
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