Title: A subset of type I variant Kounis syndrome: Allergic angina syndrome and persistent presence of coronary spasm
Abstract: Kounis syndrome is defined as the concurrent development of acute coronary syndrome, with an allergic or hypersensitivity and anaphylactic response to anaphylactoid insults [ [1] Kounis N.G. Coronary hypersensitivity disorder: the Kounis syndrome. Clin. Ther. 2013; 35: 563-571 Abstract Full Text Full Text PDF PubMed Scopus (192) Google Scholar ]. Clinical manifestations of Kounis syndrome include the spectrum of acute coronary syndromes, including coronary spasm, acute myocardial infarction, or stent thrombosis, which is associated with mast-cell and platelet activation caused by a hypersensitivity reaction [ 2 Kogias J.S. Papadakis E.X. Tsatiris C.G. Hahalis G. Kounis G.N. Mazarakis A. et al. Kounis syndrome: a manifestation of drug-eluting stent thrombosis associated with allergic reaction to contrast material. Int. J. Cardiol. 2010; 139: 206-209 Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar , 3 Kilic D. Evrengul H. Ozcan A.V. Tanriverdi H. Cagliyan O. Kaftan A. Acute ST segment elevation myocardial infarction after sulbactam-ampicilllin induced anaphylactic shock in an adult with significant coronary artery disease: a case report. Int. J. Cardiol. 2009; 135: e30-e33 Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar , 4 Gazquez V. Dalmau G. Gaig P. Gomez C. Navarro S. Merce J. Kounis syndrome: report of 5 cases. J. Investig. Allergol. Clin. Immunol. 2010; 20: 162-165 PubMed Google Scholar ]. Coronary spasm provoked by histamine release during an allergic reaction is a key mechanism leading to acute coronary events; [ [5] Kounis N.G. Zavras G.M. Histamine-induced coronary artery spasm: the concept of allergic angina. Br. J. Clin. Pract. 1991; 45: 121-128 PubMed Google Scholar ] however, it remains unclear whether coronary spasm is an insult-related, transient phenomenon during an allergic reaction or expression of a preexisting condition provoked by hypersensitivity insult. We report a case of Kounis syndrome with cardiovascular collapse that developed after the injection of medications and the persistent presence of coronary spasm documented by an ergonovine stimulation test. We also propose a sub-classification of Kounis syndrome.
Publication Year: 2016
Publication Date: 2016-11-01
Language: en
Type: letter
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 6
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