Matsushita Katsuyuki, Arai Risa, Nakayama Tetsuzo, Nakagaki Toshiaki, Kandabashi Tadashi, Yamaura Ken
Operating Rooms, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, Fukuoka, Japan.
JA Clin Rep. 2021 Apr 17;7(1):36. doi: 10.1186/s40981-021-00437-9.
Coronary artery spasm has rarely been reported in pediatric patients. Previous studies have reported comorbidities and risk factors for coronary artery spasms. We present the case of a complete atrio-ventricular (AV) block that occurred in the absence of other risk factors immediately after direct laryngoscopy.
A 2-year-old girl developed severe coronary artery spasm after direct laryngoscopy for elective laryngeal papillomatosis resection. Immediately after the initiation of laryngoscopy, complete AV block and ST elevation on lead II of the electrocardiogram were observed. These findings indicated that the complete AV block was caused by a right coronary artery spasm.
Coronary artery spasm resulting in lethal arrhythmia rarely occurs in healthy pediatric patients. To the best of our knowledge, this is the first pediatric case of a severe coronary artery spasm resulting in a complete AV block due to direct laryngoscopy in a healthy patient.
小儿患者冠状动脉痉挛鲜有报道。既往研究报告了冠状动脉痉挛的合并症和危险因素。我们报告一例在直接喉镜检查后立即发生完全性房室传导阻滞且无其他危险因素的病例。
一名2岁女童在择期行喉乳头状瘤切除术的直接喉镜检查后发生严重冠状动脉痉挛。喉镜检查开始后立即观察到完全性房室传导阻滞及心电图II导联ST段抬高。这些发现表明完全性房室传导阻滞是由右冠状动脉痉挛引起的。
健康小儿患者很少发生导致致命性心律失常的冠状动脉痉挛。据我们所知，这是首例因直接喉镜检查导致健康小儿严重冠状动脉痉挛并引起完全性房室传导阻滞的病例。
