Unusual case of intraoperative acute cor pulmonale during spine surgery

Perioperativecomplications of prolonged surgery and prone positioningare well known. Changingthe positionfrom prone to supine in an anesthetized patient can result in aspiration and airway obstruction. The drop-in oxygen saturationand hemodynamic changes are warning signs and can cause acute cardiac decompensationleading to diagnostic dilemma. We present a case where the patient had these changes after changingthe positionafter spine surgery in prone position. A quick response from the treating anesthesiologist and active involvement of cardiologist helped in reaching the diagnosis and successful management of aspiration pneumonitisin this patient. We conclude that a quick response in investigations and multimodality approach helps in the management of such perioperativecomplications.