Heart failure and anaphylactic shock – two cases

Two recent cases of anaphylaxis first thought to be heart failure call for cardiologic and allergic evaluation of heart failure during general anaesthesia.

A fifty-year-old man undergoing surgery for a hernia had an anaphylactic shock caused by succinylcholine. He had previous cardiovascular risks, and suffered cardiac arrest, after which it was suspected he’d had a massive coronary, which was treated with thrombolysis. However after a coronarography it was revealed he’d had a severe coronary vasospasm induced by anaphylaxis.

A fifty-five year old woman with no particular history, suffered an anaphylactic shock caused by cisatracurium infusion, who presented with cardiogenic shock after being injected with epinephrine.

These cases call for anaphylaxis to be suspected after the elimination of coronary thrombosis.

Source: Annales de Cardiologie et d'Angéiologie

First Published in April 2011

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