TABLE 2942 Classification of Contrast Reactions

Chemotoxic reactions are related to osmotoxic and other chemical effects of contrast agents. The pathophysiologic mechanisms for chemotoxicity are not well understood, but its occurrence is less idiosyncratic. Since many of the chemotoxic cardiovascular reactions, such as dysrhythmia and pulmonary edema, occur primarily with coronary artery injections, their occurrence in the emergency department setting is probably of less concern than in the cardiac catheterization suite.

Contrast agents can also cause vasovagal reactions, a result of increased vagal tone of the heart and blood vessels of unknown etiology but thought to be related to the central nervous system. In addition to being caused by contrast agents, vasovagal reactions may also be caused by the circumstances surrounding their administration, such as fear, anxiety, or discomfort from needle puncture.

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