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Pine needle-based products are popular dietary
supplements in East Asia for health promotion. Pine needle extract (PNE) are
especially known as potential anti-hypertensive and anti-lipidemic agents. We
report a case of profound, long-lasting unexplained hypotension during and after anesthesia in a patient
treated with PNE. Bedside transthorasic echocardiography (TTE) was used as a part of
useful diagnostic modality.