Yeungnam Univ J Med.  2012 Dec;29(2):129-131. 10.12701/yujm.2012.29.2.129.

A Case of Successful Recovery from High Dose Intravenous Nicorandil Infusion in Refractory Coronary Vasospasm with Hemodynamic Collapse

• Koh WJ
• Cho JH
• Lee JH
• Kang WS
• Lee MK
• Kim JH
• Cho DK

• KMID: 2049813
• DOI: http://doi.org/10.12701/yujm.2012.29.2.129

Abstract

A 70-year-old male came to the emergency room of the authors' hospital because of sudden cardiac arrest due to inferior wall ST elevation myocardial infarction. His coronary angiography revealed multiple severe coronary spasms in his very long left anterior descending artery. After an injection of intracoronary nitroglycerine, his stenosis improved. The cardiac arrest relapsed, however, accompanied by ST elevation of the inferior leads, while the patient was on diltiazem and nitrate medication to prevent coronary spasm. Recovery was not achieved even with cardiac massage, intravenous injection of epinephrine and atropine, and intravenous infusion of nitroglycerine. The patient eventually recovered through high-dose nicorandil intravenous infusion without ST elevation of his inferior leads. Therefore, intravenous infusion of a high dose of nicorandil must be considered a treatment option for cardiac arrest caused by refractory coronary vasospasm.

Keyword

Coronary vasospasm; Cardiopulmonary resuscitation; Nicorandil

MeSH Terms

Arteries
Atropine
Cardiopulmonary Resuscitation
Constriction, Pathologic
Coronary Angiography
Coronary Vasospasm
Death, Sudden, Cardiac
Diltiazem
Emergencies
Epinephrine
Heart Arrest
Heart Massage
Hemodynamics
Humans
Infusions, Intravenous
Injections, Intravenous
Male
Myocardial Infarction
Nicorandil
Nitroglycerin
Porphyrins
Spasm
Atropine
Diltiazem
Epinephrine
Nicorandil
Nitroglycerin
Porphyrins