Physiological Stress as Risk Factor for Hypersensitivity to Contrast Media: A Narrative Review of the Literature and a Proposal of Psychophysiological Tools for Its Detection

The use of contrast media in clinical diagnostic practice has increased significantly in recent years, accompanied by an increase in adverse reactions. These are the fleeting symptoms most complained about by patients: Flushing of the face, feeling of nausea, and heat lasting a few seconds, considered side effects related to the drug. Hypersensitivity reactions are rarer but dangerous and are driven by the immune system. To ensure the optimal management of adverse reactions to iodinated contrast media, various types of health specialists, such as radiologists, are looking into how to deal with the problem. While there are many suggestions in the scientific literature on what to do in the case of important reactions during or after radiological examination, unfortunately, there are no studies on primary and secondary prevention and, in particular, on psychophysical and psychophysiological influences. Some inferences could be made by observing the studies about psychophysiological stress and immune-inflammatory processes of allergies. The few studies in the literature on the analysis of processes affecting both psychophysiological stress and allergic responses have been analyzed. Finally, stress measurement methods are proposed that can highlight “hypersensitive” people with physiological characteristics capable of exacerbating or accentuating an allergic reaction to contrast media.