Lenalidomide-induced type II Kounis syndrome: a case report
1Department of Cardiovascular Medicine, Guiqian International General Hospital, Guiyang, Guizhou Province, China.
Frontiers in Cardiovascular Medicine
|July 1, 2025
Summary
A patient with Multiple Myeloma experienced chest pain due to lenalidomide, a chemotherapy drug. This case is the first to document lenalidomide-induced myocardial infarction, a severe heart attack.
Area of Science:
- Cardiology
- Oncology
- Pharmacology
Background:
- Kounis syndrome is an allergic reaction causing myocardial ischemia.
- Lenalidomide is a chemotherapy agent used for Multiple Myeloma.
- Previous reports linked lenalidomide to myocarditis, not myocardial infarction.
Observation:
- A Multiple Myeloma patient developed chest pain after lenalidomide administration.
- Electrocardiogram showed ST-segment depression; troponin I and eosinophils were elevated.
- Coronary angiography revealed acute thrombosis in the left anterior descending artery.
Findings:
- This case represents the first documented instance of lenalidomide-induced myocardial infarction.
- The findings suggest a novel mechanism of lenalidomide cardiotoxicity.
- Elevated eosinophils may indicate an allergic component.
Implications:
- Lenalidomide's cardiotoxic profile may be broader than previously understood.
- Clinicians should consider myocardial infarction in patients on lenalidomide presenting with chest pain.
- Further research is needed to elucidate the mechanisms of lenalidomide-induced cardiac events.
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