Variant angina, which is associated with coronary artery spam, is difficult to
recognize on routine preoperative evaluation. Coronary spasm results in
myocardial ischemia and even lethal arrhythmia in severe cases. Since patients
are unconscious and cannot complain of symptoms during general anesthesia, early
detection of such an event is difficult, and it could lead to severe bradycardia
or cardiac arrest. We report a case of a patient with previously undiagnosed
variant angina who experienced severe hypotension and ventricular fibrillation
during general anesthesia.
Early repolarization is a common electrocardiographic (ECG) feature found in young adults, men and athletes, and has been considered to be a benign feature for the last several decades. But recent studies suggest that early repolarization may be related to idiopathic ventricular fibrillation and sudden cardiac death. We report a young man, 35 years old, who had life threatening ventricular fibrillation and sudden cardiac arrest. He was evaluated for cardiac causes of ventricular fibrillation. There was no explanation other than that his ECG showed an early repolarization pattern so we treated him with implantable cardioverter defibrillator. Thus, we suggest that early repolarization may be related with life threatening ventricular arrhythmia.