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CASE REPORT
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Neostigmine induced coronary artery spasm: A case report and literature review


1 Department of Cardiology, Shaare-Zedek Medical Center, Hebrew University, Hadassah Medical School, Jerusalem, Israel
2 Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare-Zedek Medical Center, Hebrew University, Hadassah Medical School, Jerusalem, Israel

Correspondence Address:
Alexerder Ioscovich,
Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, POB 3235, Jerusalem 91031
Israel
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Source of Support: None, Conflict of Interest: None

Neostigmine is a cholinesterase inhibitor which does not cross the blood brain barrier and a commonly used for reversal of nondepolarizing muscle relaxants. In the following case report, we present a patient who developed coronary artery spasm, after the administration of repeated doses of neostigmine. Ours is the first case to demonstrate such a longstanding coronary artery vasospasm that lasted several hours in response to neostigmine, resulting in myocardial damage and left ventricular dysfunction. We would like to draw the attention of the anesthesiologists to this rare effect that may lead to perioperative cardiac complications.


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    -  Kolker S
    -  Tzivoni D
    -  Rosenmann D
    -  Meyler S
    -  Ioscovich A
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