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[A case of postoperative acute myocardial infarction due to the interruption of anticoagulant therapy].

A 67-year-old male patient was scheduled for stripping of a lower limb varix. He had received long-term anticoagulant therapy using oral warfarin because of implantation of an aortic mechanical heart valve. Warfarin therapy was discontinued 3 days before surgery to prevent excessive bleeding during the perioperative period. Anesthesia was maintained with sevoflurane and nitrous oxide in oxygen and combined with continuous epidural block. The operation was uneventful. Six hours after surgery, an electrocardiogram demonstrated ventricular fibrillation, followed by respiratory arrest. Cardiopulmonary resuscitation was started immediately, and normal sinus rhythm was restored. Coronary angiography revealed significant stenosis of coronary arteries. Percutaneous transluminal coronary angioplasty was therefore performed. Acute myocardial infarction caused by the interruption of anticoagulant therapy was suspected.