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Histamine--can it cause an acute coronary event?
1Department of Cardiology, Jersey City Medical Center, Mount Sinai School of Medicine, New Jersey, USA.
Clinical Cardiology
|April 6, 2001
Summary
Myocardial infarction (MI) can occur during allergic urticaria without low blood pressure. Histamine release from allergic reactions may cause coronary artery spasm, leading to heart attack.
Area of Science:
- Cardiology
- Allergology
- Immunology
Background:
- Myocardial infarction (MI) is typically associated with atherosclerosis and cardiovascular risk factors.
- Allergic reactions, such as urticaria, are generally not considered a direct cause of MI.
- The occurrence of MI during urticaria without hypotension is exceptionally rare.
Observation:
- A 28-year-old woman with no prior cardiovascular disease history presented with generalized urticaria.
- She experienced chest pain concurrently with the urticarial rash.
- Clinical presentation included electrocardiographic changes and elevated cardiac enzymes, indicative of acute MI.
Findings:
- The case demonstrates a direct link between acute allergic urticaria and acute myocardial infarction.
- Electrocardiographic and enzymatic evidence confirmed MI in the absence of systemic hypotension.
- Literature review suggests localized histamine release as a potential mechanism.
Implications:
- Histamine release during allergic reactions may trigger coronary artery vasospasm.
- This vasospasm can lead to myocardial ischemia and infarction, even in individuals without traditional risk factors.
- Highlights a potential, albeit rare, cardiovascular complication of allergic responses.