Iodinated contrast media in diagnostic imaging: Cardiovascular side effects

Background: Cardiovascular side effects occur rarely after iodinated contrast media administration and no real data can be found in literature. The presence of cardiovascular risk factors increases the incidence of these adverse reactions. Objective: Aim of the study was the analysis of the cardiovascular side effects due to use of intra-venous iodinated contrast media in diagnostic imaging. Methods: A MEDLINE and Pubmed research was performed for journals with MeSH major terms “iodinated contrast media” and “cardiovascular side effects”. Non-English speaking literature was excluded. Results: Intravenous iodine contrast agents could be determined with low frequency cardiovascular side effects, such as arrhythmias, related to increased levels of thyroid hormones. Indeed after the contrast media administration, in euthyroid patients the iodine stores remain elevated up to two months. Instead the vasomotor reactions (orthostatic hypotension and reflex tachycardia) and /or vasovagal response (syncope and bradycardia) are the most frequent. Conclusion: The rarity and the mild-moderate type of the cardiovascular side effects do not justify the electrocardiogram test as a preliminary exam for iodine contrast media usage. Emergency medical team should be alert in case of need. Atropine is the first choice in the hypotensive crisis due to contrast agents.