Key result
A 76-year-old man with STEMI developed severe anaphylactic shock two and a half hours after receiving a loading dose of Ticagrelor, which resolved after administration of steroids and inotropes.
Case Report (n=1)
Ticagrelor can rarely cause severe anaphylactic shock, which requires prompt recognition and management, including switching to an alternative antiplatelet agent like clopidogrel.
May prompt closer observation for delayed rash or shock after ticagrelor load; leaves open incidence and optimal P2Y12 switch.
An ST elevation myocardial infarction is life-threatening and requires urgent management. Before coronary intervention, preoperative loading a P2Y12 receptor antagonist is warranted. We present a case in which urgent coronary angiography was performed after given loading dose of Aspirin and Ticagrelor. Two and a half hours after loading Ticagrelor, patient developed hypotension with swollen face and diffuse rash on the trunk. Consideration of the anaphylactic shock, a steroid bolus and an inotropic infusion were administered and patient became hemodynamically stable. The allergic manifestations disappeared a few hours later, Ticagrelor was changed to Clopidogrel to avoid the severe allergic reaction.
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Tat et al. (2024) conducted a case report in ST elevation myocardial infarction (STEMI) and anaphylactic shock (n=1). Ticagrelor was evaluated on Anaphylactic shock. A 76-year-old man with STEMI developed severe anaphylactic shock two and a half hours after receiving a loading dose of Ticagrelor, which resolved after administration of steroids and inotropes.
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