Kounis Syndrome: Kill Two Birds With One Stone
Takehiro Yamashita1, Yasunori Oguma, Nicholas G Kounis
1Cardiology, Cardiovascular Center, Hokkaido Ohno Memorial Hospital, 2-1-16-1, Miyanosawa, Nishiku, Sapporo, Hokkaido 063-0052, Japan. t_yamashita@cvc-ohno.or.jp.
This study reports the first case of a patient experiencing two Kounis syndrome variants during a single cardiac event, highlighting complex allergic reactions in cardiology. The patient
Area of Science:
- Cardiology
- Allergy and Immunology
Background:
- Kounis syndrome (KS) is an acute coronary syndrome associated with hypersensitivity.
- Type I KS occurs without coronary artery disease, while Type II KS involves plaque erosion or rupture.
Observation:
- A 59-year-old man presented with symptoms of Type I Kounis syndrome during percutaneous coronary intervention (PCI).
- Initial treatment with nitroglycerin and epinephrine resolved symptoms, but recurrent chest pain led to new ECG changes.
- Repeat angiography revealed proximal occlusion of the diagonal branch, not vasospasm.
Findings:
- The patient experienced a unique combination of Type I and Type II Kounis syndrome variants in a single event.
- The recurrent symptoms and ECG changes were attributed to the diagonal branch occlusion.
Implications:
- This case expands the understanding of Kounis syndrome presentations.
- It underscores the importance of considering complex allergic reactions in acute coronary syndromes, even during interventions.
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