Ventricular fibrillation in a patient with exercise-induced anaphylaxis, normal coronary arteries, and a positive ergonovine test.
Exercise-induced anaphylaxis (EIA) is a rare form of physical allergy. Although histamine release is a feature of EIA, and histamine provocation of coronary spasm has been described, serious cardiac arrhythmias in EIA have not been reported. Exercise-induced anaphylaxis was diagnosed in a survivor of out-of-hospital cardiac arrest due to ventricular fibrillation after ECG signs of coronary spasm. Coronary artery disease was excluded. Ergonovine provocation induced coronary spasm in this patient. This is, to the authors' knowledge, the first description of ventricular fibrillation in EIA, possibly due to coronary spasm.
Attenhofer
C
C
Department of Internal Medicine, University Hospital of Zurich, Switzerland.
Speich
R
R
Salomon
F
F
Burkhard
R
R
Amann
F W
FW
D000707:Anaphylaxis / Q000097:blood / Q000209:etiology*; D003329:Coronary Vasospasm / Q000209:etiology*; D003331:Coronary Vessels / Q000473:pathology; D004874:Ergonovine; D005080:Exercise Test / Q000009:adverse effects; D006632:Histamine / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology; D010447:Peptide Hydrolases / Q000097:blood; D005082:Physical Exertion / Q000502:physiology; D014693:Ventricular Fibrillation / Q000209:etiology*
D006632:Histamine; D010447:Peptide Hydrolases; C023073:tosylarginine methyl ester hydrolase; D004874:Ergonovine