Atropine injection followed by coronary artery spasm with ventricular tachycardia during spinal anesthesia -A case report-

Abstract

Bradycardia may occur during spinal anesthesia with atropine commonly used as a treatment. A 44-year-old female with no known history of any underlying diseases, developed a coronary spasm following ventricular tachycardia when 0.5 mg of atropine was injected intravenously to treat bradycardia during spinal anesthesia. The imbalance caused by atropine in the sympathovagal activity may predispose the coronary artery to develop spasms with ventricular tachycardia. Therefore prudent use of atropine should be accompanied by close monitoring.

Efficacy of atropine combined with paroxetine in vagus nerve excitatory panic disorder

“…As a result, we treated her with atropine, a potent cardiac parasympatholytic blocking agent, which could increase the heart rate and is widely used to treat bradycardia. 8 To our delight, the fact demonstrates the efficacy of atropine combined with paroxetine in curing this specific case of PD.…”

Coronary artery spasm due to intravenous atropine infusion in a child: possible Kounis syndrome

“…4 Coronary vasospasm secondary to atropine is reported in only one adult patient. 5 We report, to the best of our knowledge, the first published case induced by atropine, probably secondary to a cardiac hypersensitivity, in a children.…”

“…There are few cases of coronary vasospasm reported in the paediatric literature, usually with predisposing factors such as Erythematous Systemic Lupus 3 or Kawasaki disease 4 . Coronary vasospasm secondary to atropine is reported in only one adult patient 5 . We report, to the best of our knowledge, the first published case induced by atropine, probably secondary to a cardiac hypersensitivity, in a children.…”

Ventricular tachycardia and acute heart failure induced by atropine in the treatment of bradycardia: A case report and literature review

“…Unfortunately, HR increased significantly and premature ventricular contraction occurred in the monitor, ultimately developing ventricular tachycardia (HR: 160 bpm). Previous reports presented 3 cases of tachyarrhythmias induced by atropine, [13][14][15] and the results were shown in Table 1. However, none of these case reports occurred during laparoscopic surgery.…”