Sugammadex-induced anaphylaxis can trigger allergic acute coronary syndrome and coronary stent thrombosis, highlighting the need for prompt recognition and treatment in the perioperative setting.
Warrants vigilance for allergic ACS during sugammadex anaphylaxis in stented patients; hypothesis-generating for targeted perioperative strategies.
In addition to cutaneous, gastrointestinal, hemodynamic, and respiratory symptoms, allergic reactions can induce an acute coronary syndrome in normal or atheromatous coronary arteries and can cause coronary stent thrombosis. Here, we report a case of coronary stent thrombosis due to allergic acute coronary syndrome during anaphylaxis induced by sugammadex in a female patient undergoing general anesthesia. She was emergently treated with percutaneous transluminal coronary balloon angioplasty with catecholamine, vasodilator, and intraaortic balloon support. Knowledge of perioperative allergy-triggered acute coronary syndrome is crucial for prompt and appropriate treatment.
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Kikura et al. (2019) studied this question.
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