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[Anaphylactic reaction with coronary spasm following coronarography]
M Ghannem1, T Marsepoil, S Godard
1Centre Hospitalier E. Rain, Gonesse.
Annales De Cardiologie Et D'Angeiologie
|October 1, 1993
Summary
Anaphylactic shock after iodinated contrast media injection can cause coronary artery spasms. Prompt treatment with linsidomine relieved spasms, highlighting the role of vasoactive mediators in such rare allergic reactions.
Area of Science:
- Cardiology
- Radiology
- Allergy and Immunology
Background:
- Coronary angiography frequently utilizes iodinated contrast media.
- Anaphylactic reactions to contrast media, though rare, can have serious complications.
- Understanding the pathogenesis of these reactions is crucial for patient management.
Observation:
- A case of anaphylactic shock occurred post-iodinated contrast medium injection during coronary angiography.
- The reaction was complicated by vasospasm in segments II and III of the right coronary artery.
- Linsidomine administration successfully relieved the coronary vasospasm.
Findings:
- The allergic reaction to iodinated contrast media triggered coronary artery vasospasm.
- Vasoactive mediators, including histamine and serotonin, are implicated in the pathogenesis.
- Angiography confirmed a healthy coronary artery segment after treatment.
Implications:
- Clinicians must consider coronary vasospasm as a potential complication of contrast-induced anaphylaxis.
- Pathogenesis-guided treatment strategies, involving vasoactive mediator modulation, may be effective.
- This case underscores the importance of vigilance for rare but severe adverse reactions to contrast agents.