Coronary artery spasm induced by anaphylactoid reaction to a new low osmolar contrast medium

Doyama, Kiyoshi; Hirose, Katsumi; Kosuga, Kunihiko; Kawakami, Yoshihide; Morikawa, Masaru; Tomioka, Nobuyoshi; Watanabe, Yutaka

doi:10.1016/0002-8703(90)90264-x

Cited by 15 publications

(7 citation statements)

References 6 publications

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“…Only a few cases of coronary artery spasm induced by an anaphylactoid reaction to contrast materials have been reported, 7,8 perhaps because of the low incidence of anaphylactoid reactions and difficulties in performing coronary angiography during anaphylactoid shock. Two cases of spasms of coronary arteries during anaphylactoid shock are reported, 1 in which transient ventricular tachycardia and complete atrioventricular block developed.…”

Section: Introductionmentioning

confidence: 99%

Severe Coronary Artery Spasm with Anaphylactoid Shock Caused by Contrast Medium

et al. 2006

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This study reports 2 cases of severe coronary artery spasm with anaphylactoid shock caused by contrast medium. The first patient had anaphylactoid shock in response to contrast medium and severe coronary spasms of both the left anterior descending coronary artery and the left circumflex coronary artery. The patient developed ventricular arrhythmia and complete atrioventricular block following the severe coronary spasm. The second patient had a totally occluded right coronary artery, owing to a spasm after anaphylactoid shock. Anaphylactoid shock should always be considered when persistent shock is noted after the coronary artery spasm has been relieved.

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Section: Introductionmentioning

confidence: 99%

Severe Coronary Artery Spasm with Anaphylactoid Shock Caused by Contrast Medium

et al. 2006

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“…All of the reactions for which onset time was available (13 of 16) met the time criteria for immediate onset hypersensitivity reaction. However, chemotoxic reactions can sometimes present similarly to immediate hypersensitivity reactions 17–35 . The number of patients reporting reactions far exceeds the incidence of adverse reactions to LONIC media reported by others and is well above the incidence of IgE‐mediated allergic reactions 44 .…”

Section: Discussionmentioning

confidence: 95%

“…However, chemotoxic reactions can sometimes present similarly to immediate hypersensitivity reactions. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] The number of patients reporting reactions far exceeds the incidence of adverse reactions to LONIC media reported by others and is well above the incidence of IgE-mediated allergic reactions. 44 On the other hand, the spectrum of things that the patients in this study reported being allergic to is fairly representative for patients presenting at our clinic for medical care.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of adverse reactions is lower with LONIC than with high‐osmolal contrast 1,16 . The incidence with LONIC (eg, iohexol, iopamidol, ioversol, iopromide, ioxilan), which is commonly used by interventional pain physicians, is 0.2% to 3% for mild to moderate immediate hypersensitivity reactions and 0.004% to 0.04% for life‐threatening immediate hypersensitivity reactions 17–35 …”

Section: Introductionmentioning

confidence: 99%

“…1,16 The incidence with LONIC (eg, iohexol, iopamidol, ioversol, iopromide, ioxilan), which is commonly used by interventional pain physicians, is 0.2% to 3% for mild to moderate immediate hypersensitivity reactions and 0.004% to 0.04% for life-threatening immediate hypersensitivity reactions. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Previously cited risk factors for these reactions include: women, Caucasian, elderly, and coexisting debilitating medical conditions. 36 Other predisposing factors include: asthma, cardiovascular disease, anxiety, beta-blockers, nonsteroidal anti-inflammatory drugs (NSAIDs), hematological conditions such as sickle cell and myeloma, and renal disease.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Adverse Reactions to Radiopaque Contrast Reported by Patients Presenting for Interventional Pain Procedure

2012

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Introduction: Adverse reactions to radiopaque contrast media (RCM) are well documented with a wide range of incidences reported. The objective of this study was to determine how many patients in a sample of 200 who presents for interventional pain treatments report a history of adverse reactions to RCM. Methods: Data from 200 outpatients were collected using a self‐administered questionnaire. The questionnaire was designed to obtain information about prior exposure to RCM and any adverse events plus other general information about allergic reactions including known risk factors for allergic reactions. Demographic data and information about past medical history were obtained from each patient. Results: Of the 200 patients surveyed, 16 reported having had an allergic reaction to RCM. The events met criteria for immediate hypersensitivity reaction. Chemotoxic reactions cannot be ruled out. Of factors associated with risk of allergic reaction, none were clearly more prevalent in subjects reporting an allergic reaction vs. subjects who did not. Atopic patients generally considered susceptible to contrast allergy reported no hypersensitivity reaction. The number of medications and foods the subjects reported caused them to have allergic reactions was extensive. Conclusion: Patients with a history suggestive of an immediate hypersensitivity reaction to RCM may report for interventional pain procedures normally performed with RCM. Patients who have experienced an immediate hypersensitivity reaction to RCM have increased risk for another reaction if injected again with contrast agent. Therefore, facilities should be prepared to implement measures to prevent recurrent reactions.

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Reactions to radiocontrast material

Lieberman

Seigle

1999

Clinic Rev Allerg Immunol

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Coronary artery spasm induced by anaphylactoid reaction to a new low osmolar contrast medium

Cited by 15 publications

References 6 publications

Severe Coronary Artery Spasm with Anaphylactoid Shock Caused by Contrast Medium

Severe Coronary Artery Spasm with Anaphylactoid Shock Caused by Contrast Medium

Prevalence of Adverse Reactions to Radiopaque Contrast Reported by Patients Presenting for Interventional Pain Procedure

Reactions to radiocontrast material

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