[A life-threatening situation due to the central anticholinergic syndrome in a case of severe coronary disease].

This report presents a case of central anticholinergic syndrome after general anesthesia in a patient with severe coronary heart disease. Eight years ago he had had two myocardial infarctions; after undergoing a bypass operation he suffered a third one. His angina pectoris had increased over the previous 6 months. General anesthesia was required for an ear operation; it was carried out as "balanced anesthesia" without any difficulties. After extubation, however, the patient became extremely agitated. Increasing myocardial work and oxygen consumption caused a life-threatening situation. The diagnosis was made immediately and the situation could be controlled by administration of physostigmine.