Table 1 Classification of severity and manifestation of adverse reactions to contrast media
Mild | |
|---|---|
Signs and symptoms appear self-limited without evidence of progression (e.g., limited urticaria with mild pruritis, transient nausea, one episode of emesis) and include: | |
• Nausea, vomiting | • Pallor |
• Cough | • Flushing |
• Warmth | • Chills |
• Headache | • Sweats |
• Dizziness | • Rash, hives |
• Shaking | • Nasal stuffiness |
• Altered taste | • Swelling: eyes, face |
• Itching | • Anxiety |
Treatment: Requires observation to confirm resolution and/or lack of progression and may require treatment in some cases. Patient reassurance is usually helpful. | |
Moderate | |
Signs and symptoms are more pronounced. Moderate degree of clinically evident focal or systemic signs or symptoms, including: | |
• Tachycardia/bradycardia | • Bronchospasm, wheezing |
• Hypertension | • Laryngeal edema |
• Generalized or diffuse erythema | • Mild hypotension |
• Dyspnea | |
Treatment: Clinical findings in moderate reactions frequently require prompt treatment. These situations require close, careful observation for possible progression to a life-threatening event. | |
Severe | |
Sign and symptoms are often life-threatening, including: | |
• Laryngeal edema (severe or rapidly progressing) | • Convulsions |
• Profound hypotension | • Unresponsiveness |
• Clinically manifest arrhythmias | • Cardiopulmonary arrest |
Treatment: Requires prompt recognition and aggressive treatment; manifestations and treatment frequently require hospitalization. | |