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Carboplatin-induced Kounis syndrome
Matteo Baroni1, Sarah Todd1, Francesco Pattarino1
1Cardiology Department, Policlinico San Pietro, Via Forlanini 15, 24036 Ponte S. Pietro (BERGAMO), Italy.
Chemotherapy can trigger Kounis syndrome, a rare allergic coronary vasospasm, presenting as chest pain during treatment. Prompt diagnosis and treatment with steroids and nitrates can resolve symptoms and avoid unnecessary invasive procedures.
Area of Science:
- Cardiology
- Oncology
- Pharmacology
Background:
- Lung adenocarcinoma patients undergoing chemotherapy are at risk for cardiovascular complications.
- Carboplatin chemotherapy can precipitate acute cardiac events.
- Kounis syndrome is a rare hypersensitivity reaction involving coronary arteries.
Observation:
- A 50-year-old man receiving carboplatin for advanced lung adenocarcinoma developed chest pain and rash.
- Electrocardiogram (ECG) showed an inferior lesion wave during chemotherapy infusion.
- Symptoms and ECG abnormalities resolved rapidly after administration of steroids and nitrates.
Findings:
- The patient's presentation was consistent with allergic coronary vasospasm, or Kounis syndrome.
- The reaction occurred during carboplatin infusion, suggesting a drug-induced hypersensitivity.
- Absence of enzymatic release indicated vasospasm rather than myocardial infarction.
Implications:
- Early recognition of Kounis syndrome is crucial in chemotherapy patients.
- Prompt management with steroids and nitrates can effectively treat this condition.
- Avoiding unnecessary invasive cardiac interventions is possible with correct diagnosis.
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