Acute Coronary Syndrome Induced by Intraoperative Oxytocin Use During Hysteroscopy: A Case Report and Clinical Implications

Background: Oxytocin, a peptide hormone, plays several physiological roles in the human body, particularly during childbirth and lactation. Inappropriate use of oxytocin may cause adverse events. Although acute coronary syndromes associated with oxytocin are rare, they should not be overlooked. Case: A 44-year-old female underwent hysteroscopic surgery for endometrial and cervical polyps, which were accompanied by increased menstrual flow. During the procedure, oozing from the wound was observed. To promote uterine contraction, oxytocin (10 U) was administered in 100 mL of 0.9% normal saline (NS) via slow intravenous infusion. Five minutes after the infusion, ST-segment elevation in lead II was noted. Oxytocin was immediately discontinued, and symptomatic treatment, including esmolol, was initiated. Under continuous cardiac monitoring, the dosage of medications was gradually adjusted, leading to the stabilization of vital signs, including blood pressure, heart rate, oxygen saturation, and respiration. The patient was discharged on the fifth postoperative day and has since been regularly followed up in the cardiology clinic. To date, no abnormalities have been observed. Conclusions: This case underscores the importance of thoroughly informing patients about the potential uses and adverse effects of oxytocin prior to surgery. During the procedure, strict adherence to the indications for oxytocin use and close monitoring of vital signs are essential. This case serves as a reminder of the need for vigilance in managing potential complications associated with oxytocin administration.