2017 Volume 37 Issue 5 Pages 611-615
A 62-year female patient who was a marathon runner was scheduled to undergo partial lung resection. Her preoperative electrocardiogram indicated a HR of 58 bpm, sinus rhythm, with high voltage. Anesthesia was performed with propofol, remifentanil, rocuronium, and thoracic epidural anesthesia. Fifteen min after the patient was shifted to the recovery room, her HR decreased to 26 bpm, and cardiac arrest occurred 1 min later. Resuscitation was performed with external cardiac massage and artificial ventilation via a bag valve mask. One mg epinephrine was administered intravenously, which resulted in reappearance of the pulse waveform on the ECG monitor and return to consciousness 3 minutes after the cardiac arrest. Transthoracic echocardiography did not indicate any abnormal findings in the recovery room. Postoperative interviews revealed that the patient had previously had recurrent sudden attacks of unconsciousness, which were probably due to severe self-correcting bradycardia. When a patient with an athlete’s heart undergoes anesthesia, it is necessary to understand the severity and frequency of any arrhythmia, including bradycardia.
