title: Refractory anaphylactoid shock potentiated by beta-blockers.
abstract: Allergic reactions, including anaphylactoid shock due to contrast material, are not uncommon. However, persistent anaphylactoid shock refractory to conventional therapy is rare. We present a case of refractory anaphylactoid shock during coronary angiography unresponsive to aggressive standard therapy in a patient on beta-blockers. Significant clinical improvement was noted upon administration of glucagon. Since beta-blockers are commonly used in patients with coronary artery disease, this potentially life-threatening complication has to be kept in mind with any procedure involving contrast media in patients on beta-blockers. Immediate access to glucagon by keeping it in the procedure room may be lifesaving in these situations.
authors.affiliation: Jersey City Medical Center, New Jersey, USA.
authors.forename: N
authors.initials: N
authors.lastname: Javeed
authors.forename: H
authors.initials: H
authors.lastname: Javeed
authors.forename: S
authors.initials: S
authors.lastname: Javeed
authors.forename: G
authors.initials: G
authors.lastname: Moussa
authors.forename: P
authors.initials: P
authors.lastname: Wong
authors.forename: F
authors.initials: F
authors.lastname: Rezai
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D000707:Anaphylaxis / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D000787:Angina Pectoris / Q000175:diagnosis / Q000628:therapy; D001262:Atenolol / Q000009:adverse effects*; D006328:Cardiac Catheterization; D003131:Combined Modality Therapy; D003287:Contrast Media / Q000009:adverse effects; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D007472:Iohexol / Q000009:adverse effects; D008297:Male; D008875:Middle Aged
chemical_list: D000319:Adrenergic beta-Antagonists; D003287:Contrast Media; D007472:Iohexol; D001262:Atenolol