Probable Ticagrelor-Associated Acute Asthma Exacerbation Following Percutaneous Coronary Intervention: A Case Report

A 57-year-old female with well-controlled bronchial asthma underwent percutaneous coronary intervention (PCI). Three hours after administration of a ticagrelor 180 mg loading dose, she developed severe bronchospasm, with oxygen saturation decreasing from 100% to below 90%. The patient received nasal mask oxygen, repeated nebulization with budesonide suspension, salbutamol, and ipratropium bromide, along with concurrent intravenous methylprednisolone. She was discharged from the ICU within 48 hours; clopidogrel 75 mg was substituted, and there was no recurrence. Severe acute asthma attacks, though rare, possibly induced by ticagrelor, require prompt recognition and aggressive management to prevent respiratory failure during PCI.