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Anaphylaxis associated with relative bradycardia.

¹Medical Service, Veterans Administration Medical Center, Allen Park, MI.

Annals of Allergy

|June 1, 1989

Summary

Anaphylaxis, a severe allergic reaction, can present with slow heart rate, mimicking vasovagal syncope. Early recognition is crucial for proper allergic reaction management.

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Area of Science:

Allergy and Immunology
Cardiology
Emergency Medicine

Background:

Hyposensitization therapy involves allergen injections to manage allergic conditions like rhinoconjunctivitis and asthma.
Anaphylaxis is a critical allergic reaction that requires prompt diagnosis and management.

Observation:

A 31-year-old male patient experienced anaphylaxis post-allergen injection during hyposensitization.
The patient exhibited relative sinus bradycardia (slow heart rate) at the onset of the anaphylactic episode.

Findings:

The case highlights that anaphylaxis can initially present without tachycardia, making it difficult to distinguish from vasovagal syncope.
Potential pathophysiological mechanisms include right coronary vasospasm leading to the Bezold-Jarish reflex or sinoatrial node ischemia.

Implications:

Clinicians must consider anaphylaxis even in the absence of initial tachycardia.
Differentiating anaphylaxis from vasovagal syncope is critical for appropriate and timely treatment of allergic emergencies.

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