Early diffuse coronary artery spasm after heart valve surgery in the carcinoid syndrome.

BACKGROUND

Coronary spasm has been described in the context of carcinoid heart disease, but few information are available over perioperative coronary spasm.

METHODS

We describe the case of a patient developing severe spasm of the entire coronary tree immediately after tricuspid valve surgery for carcinoid heart disease, leading to severe myocardial failure.

RESULTS

The spasm was diagnosed by coronary angiography and resolved by intracoronary injection of trinitrine. We present the angiographic features of simultaneous spasm of all coronary arteries and of its evolution.

CONCLUSION

The present case illustrates the likelihood of perioperative spasm of the entire coronary tree in carcinoid heart disease, and the usefulness of coronary angiography for both diagnosis and treatment.