3-Dimensional optical frequency domain imaging for the evaluation of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction

Abstract

occasion she was also found affected by allergy to iodinated contrast media”, but the paper provides no information concerning the kind of reaction (clinical features [4]), the severity, the number of reactions, the time of onset after the contrast medium has been injected, the results of an allergological work-out (was it true allergic reaction or a non-allergic reaction? [5]), possible risk factors (e.g. allergic asthma [6]) and last but not least the time point of the last CM-reaction is also missing. Especially, the last fact is of great importance for this case. A CM-hypersensitivity reaction that occurred more than 7 days before the onset of the Kounis syndrome seems to be an isolated reaction without causative connection to a contrast medium injection. This assumption is further supported by the fact that the authorswrote: “... chemotherapy with cisplatin and cyclophosphamide. After the second administration of these drugs she developed intense chest pain...” [1]. This is a clear hint for the assumption that the presented patient could have a hypersensitivity to chemotherapy that could be also related to the Kounis syndrome. In conclusion, cardiac complaint after iodinated contrast medium injection is currently an unsolved problem, and “allergic angina” could be the reason for it in some patients. Detailed clinical information on allergic reactions in general or hypersensitivity reactions to iodinated contrast media in particular are necessary to clearly relate reactions to suspected compounds. Furthermore, to facilitate a safe use of iodinated contrast media in patients with previous reactions detailed clinical information is very important. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology (Shewan and Coats 2010;144:1–2).