Variant angina, which is associated with coronary artery spam, is difficult to
recognize on routine preoperative evaluation. Coronary spasm results in
myocardial ischemia and even lethal arrhythmia in severe cases. Since patients
are unconscious and cannot complain of symptoms during general anesthesia, early
detection of such an event is difficult, and it could lead to severe bradycardia
or cardiac arrest. We report a case of a patient with previously undiagnosed
variant angina who experienced severe hypotension and ventricular fibrillation
during general anesthesia.