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Can Anaphylactic Reaction Cause A Septal MI?

Posted on Tue, 2 Dec 2014

Question: Can anaphylactic reaction cause a septal MI

Patient with PCN allergy In XXXXXXX patient given Rocephin, cefdinir NO reaction
In November given Rocephin ?anaphylactic reaction/bronchospasm Found unresponsive 7 minutes later

Patient revived EKG showed septal MI

Answered by Dr. Senduran Narayanasamy (1 hour later)

Brief Answer:
Rarely can precipitate.

Detailed Answer:
Hello there.Welcome to healthcaremagic.

I am Dr.Senduran,General physician answering your query..

Usually in patients with normal coronary arteries, anaphylaxis doesn't seem to induce an ischemia or MI. It can however occur in suspected individuals with prior atherosclerosis in the coronary arteries especially aged over 60 yrs, diabetics.

Does the patient have any preexisting cardiac illness or comorbid conditions like diabetes, obesity etc ?

With the limited information and considering patient's old age,my opinion would be that,this cardiovascular accident(Septal MI) might have got precipitated due to anaphylaxis.

Reply back with needed information to comment better..

Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Senduran Narayanasamy (1 hour later)

I do not think the patient was diabetic, but she did have COPD and the Xray showed L lower lobe pneumonia and granulated tissue mid R lung

Patient was observed coughing in waiting area and then walked out of waiting area and was found lying on floor by husband as he left.

Answered by Dr. Senduran Narayanasamy (5 hours later)

Brief Answer:
Exacerbation of COPD likely to be the trigger

Detailed Answer:
Hello again,

Patients with COPD are at increased risk of acute cardiovascular events like myocardial infarction. Both lungs and heart depend on each other for maintaining their normal functions i.e if heart fails, subsequently lungs too would suffer and vice versa.

Acute exacerbation of COPD due to anaphylactic reaction and atleast a minimal or asymptomatic atherosclerosis of coronary arteries were likely to be the cause for evolution of septal MI in the patient.

Hope I have answered your query.Please close and rate this discussion if you don't have further queries.

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Senduran Narayanasamy (4 hours later)

If you take anaphylactic reaction out as the patient had been on omnicef in the past and had Rocephin in the past could the other diagnoses cause the septal MI on their own. Is it possible she could have had a bronchospasm?

Answered by Dr. Senduran Narayanasamy (37 minutes later)

Brief Answer:
Yes,of course

Detailed Answer:
Hello again,

In such case, when the patient had been using beta lactam group of antibiotics(Penicillin and cephalosporins like omnicef,rocephin) safely without any allergic reactions, the patient wouldn't get acute bronchospasm(component of anaphylactic reaction) with rocephin like drugs.

However, still myocardial infarction could be possible independently if we have taken out the anaphylaxis from the context. But MI is relatively uncommon in women. It could occur in this patient because of preexisting coronary artery disease(undiagnosed) especially in association with chronic obstructive pulmonary disease.

Hope this information helps you.

Regards

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Above answer was peer-reviewed by : Dr. Shanthi.E