CASE REPORT
Unstable angina following anaphylaxis
1 Department of Clinical Immunology, Auckland City Hospital, Grafton, Auckland, New Zealand
2 Department of Cardiology, Auckland City Hospital, Grafton, Auckland, New Zealand
3 Department of Cardiology, North Shore Hospital, Takapuna, North Shore City, New Zealand
Correspondence to:
Associate Professor R Ameratunga, Department of Clinical Immunology, Auckland City Hospital, Park Road, Grafton, Auckland 1001, New Zealand; rohana{at}adhb.govt.nz
A 55-year-old woman developed unstable angina following an episode of severe anaphylaxis which was treated with 0.5 mg intramuscular epinephrine (adrenaline). The exact cause of her ongoing unstable angina was uncertain but may have reflected either vasospasm superimposed upon an area of atherosclerotic coronary disease, or vasospasm induced plaque rupture. Four weeks later, she had a second episode of anaphylaxis, and suffered a cardiac arrest after receiving a bolus of intravenous epinephrine. This case illustrates the importance of careful assessment of patients after anaphylaxis, both to prevent recurrence and to treat complications from the episode. It highlights the dangers of intravenous epinephrine in treating anaphylaxis outside anaesthetic and intensively monitored settings.
Keywords: accident and emergency medicine; immunology; ischaemic heart disease; anaphylaxis; salicylates; sulfites; unstable angina
Read all eLetters
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
eLetters:
- Full Text
- Full Text (PDF)
- Submit a response
- Read responses to this article
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Drugs: cardiovascular system
-
Drugs: CNS (not psychiatric)
-
Ischaemic heart disease
- Immunology (including allergy)
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
