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Case report: Ioversol induced Kounis syndrome and cardiogenic shock

Baoguo Wang1, Weihua Zhang1, Yu Fu1

  • 1Department of Cardiology, First Hospital of Jilin University, Changchun, China.

Heliyon
|May 1, 2023
PubMed

Insights

A patient experienced Kounis syndrome type II, a severe allergic reaction causing coronary artery spasm and cardiogenic shock, during a cardiac procedure. Prompt treatment successfully relieved the spasm and stabilized the patient.

Area of Science:

  • Cardiology
  • Allergy and Immunology
  • Pharmacology

Background:

  • Coronary angiography is a standard procedure for diagnosing coronary artery disease.
  • Ioversol is a non-ionic contrast agent commonly used in angiography.
  • Kounis syndrome is an allergic reaction involving the cardiovascular system.

Observation:

  • A 50-year-old male presented with chest pain and underwent coronary angiography.
  • During the procedure, the patient developed sudden dyspnea, flushing, and hypotension.
  • Angiography revealed severe left coronary artery spasm and stenosis.

Findings:

  • The patient was diagnosed with type II Kounis syndrome, a severe allergic reaction triggered by ioversol.
  • The syndrome manifested as acute coronary artery spasm and cardiogenic shock.
  • Treatment with antianaphylaxis, vasopressors, fluids, and intracoronary nitroglycerin resolved the coronary spasm.

Implications:

  • This case highlights the potential for contrast agents to induce severe allergic reactions like Kounis syndrome.
  • Early recognition and prompt management are crucial for improving outcomes in contrast-induced cardiovascular emergencies.
  • Further research into the mechanisms and prevention of contrast-induced Kounis syndrome is warranted.

Keywords:
AllergyCardiogenic shockCoronary spasmIoversolKounis syndrome

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