Coronary Vasospasm with Complete Heart Block Following Ivor-Lewis Esophagectomy Treated with Glycopyrrolate: A Case Report


Vol 8 | Issue 3 | September-December 2022 | Page: 09-11 | David Guz, Angela Johnson, Connor McNamara

DOI: 10.13107/jaccr.2022.v08i03.207

Author: David Guz [1], Angela Johnson [2], Connor McNamara [2]

[1] Detroit Medical Center/Wayne State University, Detroit, MI 48201.
[2] University Hospitals Cleveland Medical Center, 11100 Euclid Ave., Cleveland, OH 44106.

Address of Correspondence
Dr. David Guz,
Detroit Medical Center/Wayne State University, 3990 John R St., Detroit, MI 48201.


We describe a patient with minimal cardiac risk factors who developed transient myocardial ischemia and complete heart block demonstrated on electrocardiography in the setting of recent esophagectomy likely caused by coronary vasospasm. The ischemic changes on ECG resolved within minutes following administration of glycopyrrolate, suggesting increased vagal tone leading to coronary vasospasm as a possible etiology. Coronary vasospasm is an uncommon cause of myocardial ischemia in the perioperative period. Anesthesiologists should be aware of coronary vasospasm as a clinical entity and its management when confronted with new-onset myocardial ischemia in the perioperative period. Written informed consent was obtained from patient prior to submission of this case report for publication.
Keywords: Coronary vasospasm, Esophagectomy, Major adverse cardiac event


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How to Cite this Article: Guz D, Johnson A, McNamara C |  Coronary Vasospasm with Complete Heart Block Following Ivor-Lewis Esophagectomy Treated with Glycopyrrolate: A Case Report | Journal of Anaesthesia and Critical Care Case Reports | September-December 2022; 8(3): 09-11.

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