ST elevation in inferior derivation, coronary ectasia, and slow coronary flow following ceftriaxone use

Area of Science:

• Cardiology
• Allergology
• Pharmacology

Background:

• Antibiotic-induced hypersensitivity reactions can manifest in various ways.
• Acute coronary syndrome (ACS) is a serious cardiac condition.
• Ceftriaxone is a commonly used third-generation cephalosporin antibiotic.

Observation:

• A 24-year-old male experienced ST-elevation myocardial infarction (STEMI) post-ceftriaxone administration.
• Coronary angiography showed right coronary artery ectasia and slow flow; left coronary system was normal.
• The patient received standard ACS treatment including antiplatelets, anticoagulants, steroids, and antihistamines.

Findings:

• The case presents a potential association between ceftriaxone-induced allergy and acute coronary events.
• Right coronary artery ectasia and slow flow suggest a possible inflammatory or vasospastic mechanism.
• Prompt medical intervention managed the acute cardiac event.

Implications:

• This case underscores the importance of considering drug-induced allergic reactions in the differential diagnosis of ACS.
• Further research is warranted to elucidate the pathophysiology linking ceftriaxone allergy to coronary events.
• Clinicians should be vigilant for potential cardiovascular complications following antibiotic administration.