Stress-related cardiomyopathy due to anaphylaxis to iodinated contrast media during arteriography procedures in diabetic patient

Ketut Suryana, I Gede Yudha Kartika


Anaphylaxis is an acute, severe systemic allergic reaction that can be potentially fatal. It can often transition to refractory hemodynamic instability (new onset myocardial dysfunction/ left ventricular dysfunction/LVD). Stress-related cardiomyopathy (SRC) is now emerging as a significant contributor of myocardial dysfunction and has multifactorial etiologies, including the excessive catecholamine released in intense stress conditions. It is also more likely to occur in middle aged/ postmenopausal woman. This rare case report, a SRC caused by contrast-induced anaphylaxis within 30 minutes post artheriography procedures. Management of anaphylaxis should be prompt and precise because it is considered as a medical emergency with a rapid onset of disease and potentially progress to cardiovascular and respiratory collapse causing death.


Anaphylaxis, Allergic reaction, Iodinated contras media, Adrenaline, SRC

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Schönmann C, Brockow K. Adverse reactions during procedures: Hypersensitivity to contrast agents and dyes. Ann Allergy Asthma Immunol. 2020;124(2):156-64.

Pasternak JJ, Williamson EE. Clinical pharmacology, uses, and adverse reactions of iodinated contrast agents: a primer for the non-radiologist. Mayo Clin Proc. 2012;87(4):390-402.

Cha MJ, Kang DY, Lee W, Yoon SH, Choi YH, Byun JS et al. Hypersensitivity reactions to iodinated contrast media: a multicenter study of 196 081 patients. Radiology. 2019;293(1):117-24.

Shaker MS, Wallace DV, Golden DBK, Oppenheimer J, Bernstein JA, Campbell RL et al. Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol. 2020;145(4):1082-123.

Fischer D, Vander Leek TK, Ellis AK, Kim H. Anaphylaxis. Allergy Asthma Clin Immunol. 2018;14(2):54.