Coronary Artery Occlusion with Sharp Blood Pressure Drop during General Anesthesia Induction: A Case Report
Most anesthetics reduce cardiac functions and lower blood pressure (BP), potentially causing excessive BP reduction in dehydrated patients or those with heart conditions, such as coronary artery disease (CAD). Considering the increased prevalence of cardiovascular disease with age, anesthesiologists...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/60/2/232 |
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| author | Jae Young Ji Yong Han Seo Ho Soon Jung Hea Rim Chun Jin Soo Park Woo Jong Kim Jae Min Ahn Yu Jun Park Ye Eun Shin Chan Ho Park |
| author_facet | Jae Young Ji Yong Han Seo Ho Soon Jung Hea Rim Chun Jin Soo Park Woo Jong Kim Jae Min Ahn Yu Jun Park Ye Eun Shin Chan Ho Park |
| author_sort | Jae Young Ji |
| collection | DOAJ |
| description | Most anesthetics reduce cardiac functions and lower blood pressure (BP), potentially causing excessive BP reduction in dehydrated patients or those with heart conditions, such as coronary artery disease (CAD). Considering the increased prevalence of cardiovascular disease with age, anesthesiologists must be cautious about BP reduction during general anesthesia in older adults. In the present case, a 76-year-old male patient with undiagnosed CAD in a hypovolemic state experienced a significant drop in systolic BP to the fifties during propofol and sevoflurane anesthesia. Despite the use of vasopressors, excessive hypotension persisted, leading to anesthesia suspension. Subsequent cardiac examinations, including computed tomography heart angio and calcium score, and coronary angiogram, revealed a near total occlusion of the proximal left anterior descending coronary artery (pLAD) and the formation of collateral circulation. After 5 days of hydration and anticoagulation medications and confirmation of normovolemic state, general anesthesia was attempted again and successfully induced; a normal BP was maintained throughout the surgery. Thus, it is important to conduct a thorough cardiac evaluation and maintain normovolemia for general anesthesia in older adults. |
| first_indexed | 2024-03-07T22:22:49Z |
| format | Article |
| id | doaj.art-62eb4c525d654818994191d62e49d855 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-07T22:22:49Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-62eb4c525d654818994191d62e49d8552024-02-23T15:26:30ZengMDPI AGMedicina1010-660X1648-91442024-01-0160223210.3390/medicina60020232Coronary Artery Occlusion with Sharp Blood Pressure Drop during General Anesthesia Induction: A Case ReportJae Young Ji0Yong Han Seo1Ho Soon Jung2Hea Rim Chun3Jin Soo Park4Woo Jong Kim5Jae Min Ahn6Yu Jun Park7Ye Eun Shin8Chan Ho Park9Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of KoreaDepartment of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of KoreaDepartment of Neurosurgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of KoreaDepartment of Radiology, Soonchunhyang University Hospital Cheonan, 31, Sooncheonhyang 6-gil, Donam-gu, Cheonan 31151, Republic of KoreaMost anesthetics reduce cardiac functions and lower blood pressure (BP), potentially causing excessive BP reduction in dehydrated patients or those with heart conditions, such as coronary artery disease (CAD). Considering the increased prevalence of cardiovascular disease with age, anesthesiologists must be cautious about BP reduction during general anesthesia in older adults. In the present case, a 76-year-old male patient with undiagnosed CAD in a hypovolemic state experienced a significant drop in systolic BP to the fifties during propofol and sevoflurane anesthesia. Despite the use of vasopressors, excessive hypotension persisted, leading to anesthesia suspension. Subsequent cardiac examinations, including computed tomography heart angio and calcium score, and coronary angiogram, revealed a near total occlusion of the proximal left anterior descending coronary artery (pLAD) and the formation of collateral circulation. After 5 days of hydration and anticoagulation medications and confirmation of normovolemic state, general anesthesia was attempted again and successfully induced; a normal BP was maintained throughout the surgery. Thus, it is important to conduct a thorough cardiac evaluation and maintain normovolemia for general anesthesia in older adults.https://www.mdpi.com/1648-9144/60/2/232coronary artery diseasedehydrationpropofolsevoflurane |
| spellingShingle | Jae Young Ji Yong Han Seo Ho Soon Jung Hea Rim Chun Jin Soo Park Woo Jong Kim Jae Min Ahn Yu Jun Park Ye Eun Shin Chan Ho Park Coronary Artery Occlusion with Sharp Blood Pressure Drop during General Anesthesia Induction: A Case Report Medicina coronary artery disease dehydration propofol sevoflurane |
| title | Coronary Artery Occlusion with Sharp Blood Pressure Drop during General Anesthesia Induction: A Case Report |
| title_full | Coronary Artery Occlusion with Sharp Blood Pressure Drop during General Anesthesia Induction: A Case Report |
| title_fullStr | Coronary Artery Occlusion with Sharp Blood Pressure Drop during General Anesthesia Induction: A Case Report |
| title_full_unstemmed | Coronary Artery Occlusion with Sharp Blood Pressure Drop during General Anesthesia Induction: A Case Report |
| title_short | Coronary Artery Occlusion with Sharp Blood Pressure Drop during General Anesthesia Induction: A Case Report |
| title_sort | coronary artery occlusion with sharp blood pressure drop during general anesthesia induction a case report |
| topic | coronary artery disease dehydration propofol sevoflurane |
| url | https://www.mdpi.com/1648-9144/60/2/232 |
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