Acute myocardial infarction after intravenous radiographic contrast medium

Acute myocardial infarction after the use of intravenous radiographic contrast medium (RCM) is rare. There is only one reported case in the literature; this is the second case. A 65-year-old woman complained of pain in the right costovertebral area, and abdominal ultrasonography showed hydronephrosis. She had insulin-dependent diabetes and hypertension. Intravenous pyelogram, using renographin, was performed. Within 5 minutes, she felt bad and became hypotensive and diaphoretic. Laboratory studies and electrocardiography confirmed the diagnosis of acute myocardial infarction. Generally, elderly and diabetic patients with abnormal renal function are considered to be at high risk for adverse reactions to RCM. Renal function was normal. It has also been reported that high R osmolality RCM such as renographin, is associated with a greater risk of adverse reactions compared with the use of low-osmolar RCM. This case should raise awareness regarding acute myocardial infarction as a complication after the use of intravenous RCM.