Acute Myocardial Infarction Following Intravenous Urography—A Case Report

Abstract

CreatinineKinase (CK) CASE REPORTA 72 year old man with no past history of ischae.dc heart disease was admitted on 27/3/79 with low back pains following a fall down the stairs. He also noticed some terminal dribbling during micturition and a rectal examination revealed that the prostate gland felt rather hard. The provisional diagnosis was acute back strain and prostatomegaly for investigation. His back strain settled down rapidly in hospital and he was advised to have an intravenous urogram.The intravenous urogram was performed on 5/4/79 and 60 ml of sodium diatrizoate was injected intravenously over one minute. About five minutes after the injection the patient complained of coldness and shortness of breath. He was observed to be sweaty and slightly dyspnoeic. His blood pressure had dropped from a baseline of 160/100mmHg. to 100/80mmHg. He also developed generalized urticaria.Hydrocortisone 100 mg and promethazine 25 mg. were given intravenously together with intranasal oxygen. However, the patient developed a central oppressive chest pain radiating to his left shoulder and hand about twenty minutes after the injection of contrast. It was also noted that he was sweating profusely. The urogram was aban-985 140 ' Medical Registrar, Modbury Hospital. 'Senior Physician, Modbury Hospital. 'Staff Radiologist, Modbury Hospital.