title: Severe coronary artery spasm with anaphylactoid shock caused by contrast medium--case reports.
abstract: 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.
authors.affiliation: Second Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Charles Chao-Yung
authors.initials: CC
authors.lastname: Wang
authors.forename: Shang-Hung
authors.initials: SH
authors.lastname: Chang
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Chen
authors.forename: Hsuan-Li
authors.initials: HL
authors.lastname: Huang
authors.forename: I-Chang
authors.initials: IC
authors.lastname: Hsieh
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D004298:Dopamine / Q000008:administration & dosage / Q000627:therapeutic use; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007472:Iohexol / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D000316:Adrenergic alpha-Agonists; D002316:Cardiotonic Agents; D003287:Contrast Media; D007472:Iohexol; D004298:Dopamine; D004837:Epinephrine