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Postgrad Med J 2008;84:659-661 doi:10.1136/pgmj.2008.071688
  • Case report

Unstable angina following anaphylaxis

  1. R Ameratunga1,
  2. M Webster2,
  3. H Patel3
  1. 1
    Department of Clinical Immunology, Auckland City Hospital, Grafton, Auckland, New Zealand
  2. 2
    Department of Cardiology, Auckland City Hospital, Grafton, Auckland, New Zealand
  3. 3
    Department of Cardiology, North Shore Hospital, Takapuna, North Shore City, New Zealand
  1. Associate Professor R Ameratunga, Department of Clinical Immunology, Auckland City Hospital, Park Road, Grafton, Auckland 1001, New Zealand; rohana{at}adhb.govt.nz
  • Received 15 May 2008
  • Accepted 8 October 2008

Abstract

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.

Footnotes

  • Competing interests: None declared.

  • Patient consent: Obtained

Responses to this article

  • Re: Intravenous epinephrine?
    • Rohan V Ameratunga,
    • Hitesh Patel, Mark Webster
    Postgrad Med J published online April 2, 2009
  • Intravenous epinephrine?
    • Kevin Theintun
    Postgrad Med J published online April 2, 2009

This Article

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