Kawachi Aya, Sudo Saho, Ishida Yusuke, Nakazawa Koichi
Department of Anesthesiology Tokyo Medical University Tokyo Japan.
Clin Case Rep. 2023 Jul 5;11(7):e7641. doi: 10.1002/ccr3.7641. eCollection 2023 Jul.
Coronary angina due to low estrogen is relatively common around menopause, with almost no reports associated with the menstrual cycle or anesthetic management at younger ages. The patient was a 22-year-old woman who had developed ventricular fibrillation due to coronary spasm, resulting in cardiopulmonary arrest. She was resuscitated, and underwent ICD implantation. As her symptoms appeared at specific times during her menstrual cycle, she was diagnosed as having menstrual-associated coronary spasm, and started taking estrogen/progesterone medication. An endometrial ablation was scheduled for endometrial hyperplasia that was caused by the medicine. The surgery was scheduled in consideration of the patient's menstrual cycle, and general anesthesia was selected as the method of anesthesia. The surgery and perioperative management were uneventful, and her postoperative course was favorable. Our case is the first to our knowledge of general anesthesia performed on a patient with menstrual-associated coronary spasm.
低雌激素引起的冠状动脉性心绞痛在围绝经期相对常见，而关于年轻女性月经周期或麻醉管理相关的报道几乎没有。该患者为一名22岁女性，因冠状动脉痉挛发生心室颤动，导致心肺骤停。她经复苏后接受了植入式心律转复除颤器（ICD）植入术。由于其症状在月经周期的特定时间出现，她被诊断为月经相关性冠状动脉痉挛，并开始服用雌激素/孕激素药物。因药物引起子宫内膜增生，计划进行子宫内膜切除术。手术根据患者月经周期安排，选择全身麻醉作为麻醉方法。手术及围手术期管理顺利，术后恢复良好。据我们所知，我们的病例是首例对月经相关性冠状动脉痉挛患者实施全身麻醉的案例。
