Adverse Drug Reactions Journal 2017;19(6):471-472
doi:10.3760/cma.j.issn.1008-5734.2017.06.017
Acute myocardial infarction induced by ultravist solution caused anaphylactoid reaction
Zeyu JIANG 1 ; Shanglang CAI 1
Affiliations
Keywords
Iopromide; Myocardial in farction
Country
China
Language
Chinese
Abstract
A 67-year-old female patient underwent the hypersensitivity test of ultravist solution before doing adrenal enhancement CT. Fifteen minutes after intravenous injection of 2 ml of ultravist solution,the patient developed palpitation,chest pain,vomiting,weakness,and hyperhidrosis. Her blood pressure was 90 / 60 mmHg. She was considered to have contrast agent anaphylactic shock. The patient received intravenous injection of dexamethasone 5 mg and IV infusion of 0. 9% sodium chloride injection 500 ml immediately. Two minutes later,her blood pressure elevated to 145 / 90 mmHg,but the chest pain was not relieved. The results of electrocardiogram showed tilted elevation on ST segment in II,III,aVF leads and declivous depression on ST segment in leads I and aVL. She was diagnosed as acute myocardial infarction. The patient immediately received aspirin enteric-coated tablet 300 mg and clopidogrel hydrogen sulfate 300 mg by chewing,hypodermic injection of low-molecular-weight heparin calcium injection 4100 U, and continuous intravenous pumping of isosorbide dinitrate injection 50 mg at speed of 2 mg/ h. One hour later, the patient′s thoracalgia was remission. She received the treatments of anti-coagulation,stable plaque,anti-hypertension,and expanding coronary artery sequentially. Thirteen days later,the hypersensitive test of ultravist solution was underwent again,the patient did not show any obvious discomfort for 24 hours. It was indicated that the patient′ s acute myocardial infarction appeared in the first hypersensitive test was the anaphylactoid reaction induced by ultravist solution.
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