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An immediate generalized reaction to iopamidol.
P A Greenberger1, L Gutt, N M Sheridan
1Department of Medicine, /sections of /allergy-Immunology and Cardiology, Northwestern University Medical School, Chicago.
Archives of Internal Medicine
|December 1, 1987
Summary
Lower-osmolality contrast media are safer but can still cause severe reactions. This case highlights a rare, immediate reaction including significant hypotension during cardiac catheterization.
Area of Science:
- Radiology
- Cardiology
- Pharmacology
Background:
- Lower-osmolality contrast media (LOCM) are preferred over higher-osmolality media due to a lower incidence of adverse events.
- While generally safe, immediate generalized reactions to LOCM, such as urticaria or bronchospasm, have been occasionally reported.
Observation:
- A 69-year-old male patient, with no prior contrast medium exposure, underwent cardiac catheterization.
- During the procedure, the patient experienced chest tightness, periorbital and facial edema, mild uvular edema, and a significant drop in blood pressure.
Findings:
- This case represents the first documented instance of an immediate generalized reaction to a lower-osmolality contrast medium that included significant hypotension.
- The patient's blood pressure decreased from 150/71 mm Hg to 97/67 mm Hg.
Implications:
- The findings underscore that even lower-osmolality contrast media are not entirely without risk.
- Clinical vigilance and the immediate availability of emergency treatment protocols are crucial when administering these agents.