scholarly journals Epirubicin-induced Kounis syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui-zhu Liang ◽  
Hong Zhao ◽  
Jian Gao ◽  
Cheng-fu Cao ◽  
Wei-min Wang
Keyword(s):  
Troponin I ◽  
Coronary Artery Spasm ◽  
Elevated Troponin ◽  
Kounis Syndrome ◽  
Case Presentation ◽  
Coronary Syndrome ◽  
Systemic Allergic Reaction ◽  
Appropriate Treatment ◽  
Prompt Diagnosis ◽  
Recurrent Bladder Cancer

Abstract Background Kounis syndrome is an acute coronary syndrome that appears in the setting of anaphylactic reaction or hypersensitivity. Many drugs and environmental exposures have been identified as potential offenders, and diagnosis and treatment can be challenging. Case presentation A 62-year-old man with recurrent bladder cancer underwent an intra-iliac artery epirubicin injection. After the injection, he developed chest pain and a systemic allergic reaction, with electrocardiographic alterations and elevated troponin-I levels. Emergent coronary angiography showed right coronary artery spasm and no stenosis of the other coronary arteries. This reaction was considered compatible with an allergic coronary vasospasm. A diagnosis of Kounis syndrome was made. Conclusions Kounis syndrome is common, but a prompt diagnosis is often not possible. This case is the first to suggest that an intraarterial epirubicin injection could potentially be one of its triggers. All physicians should be aware of the pathophysiology of this condition to better recognize it and start appropriate treatment; this will prevent aggravation of the vasospastic cardiac attacks and yield a better outcome.

scholarly journals KOUNIS SYNDROME - ALLERGIC MYOCARDIAL INFARCTION. A CASE REPORT

2019 ◽  
Vol 72 (1) ◽  
pp. 137-141
Author(s):  
Olga Wajtryt ◽  
Tadeusz M Zielonka ◽  
Aleksandra Kaszyńska ◽  
Andrzej Falkowski ◽  
Katarzyna Życińska
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Allergic Reaction ◽  
Anaphylactic Shock ◽  
Coronary Artery Spasm ◽  
Kounis Syndrome ◽  
Permanent Damage ◽  
Coronary Syndrome

Kounis syndrome or allergic myocardial infarction is an acute coronary syndrome in the course of an allergic reaction. In allergic patients in response to a specific condition - nourishment, inhalation, environmental substances, drug or insect bite there is an allergic reaction involving many different cells and mediators that can cause coronary artery spasm or initiate the process of rupture and activation of atherosclerotic plaque resulting in acute coronary syndrome. The paper describes a case of a young man with allergy to pollen and confirmed sensitization to nuts, who developed a full-blown anaphylactic shock after eating the nut mix and experienced a rapidly passing acute coronary syndrome with troponin up to 4.7 μg/L. An increased concentration of tryptase (15 μg/L), total IgE (> 3,000 IU/mL) and specific anti-nut IgE (55.1 kUA/L) were found. Based on the course of the disease and the results of allergic and cardiac tests, allergic type 1 myocardial infarction, i.e. caused by coronary artery spasm, was diagnosed. During the hospitalization, the patient’s condition improved quickly and after a few days he left the hospital without the signs of permanent damage to the heart muscle.

scholarly journals Kounis syndrome uncovers severe coronary disease: an unusual case of acute coronary syndrome secondary to allergic coronary vasospasm

2019 ◽  
Vol 12 (12) ◽  
pp. e232472
Author(s):  
Luca Conti ◽  
Kelly Gatt ◽  
Christopher Zammit ◽  
Karen Cassar
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
High Signal ◽  
Type I ◽  
Kounis Syndrome ◽  
Coronary Syndrome ◽  
Triple Vessel Disease ◽  
Appropriate Treatment ◽  
St Elevation ◽  
Type I Hypersensitivity

Acute coronary syndrome occurring during the course of a type I hypersensitivity reaction constitutes Kounis syndrome. We report a case of a 64-year-old man who presented with a non-ST elevation myocardial infarction and peripheral blood eosinophilia. He had rhinitis and constitutional symptoms for several days prior to presentation. Blood investigations revealed moderate eosinophilia and elevated IgE levels. A cardiac MRI showed generalised oedema with a subtle wall motion abnormality in basal inferior/inferolateral wall, and subendocardial high signal on late gadolinium enhancement suggesting a localised myocardial infarction. A coronary angiogram then revealed triple vessel disease. A diagnosis of Kounis syndrome was made. Within days of starting appropriate treatment, the patient’s eosinophil count returned to normal with improvement of clinical picture.

scholarly journals Illicit Drugs Breaking One Heart at a Time

2018 ◽  
Vol 02 (02) ◽  
pp. 102-104
Author(s):  
Ayman Battisha
Keyword(s):  
Heart Failure ◽  
Coronary Atherosclerosis ◽  
Illicit Drugs ◽  
Troponin I ◽  
Alcohol Intoxication ◽  
Acute Alcohol Intoxication ◽  
Coronary Angiogram ◽  
Elevated Troponin ◽  
Coronary Syndrome ◽  
Psychological Stressors

AbstractTakotsubo cardiomyopathy (TCM) is triggered by multiple physical and psychological stressors and frequently mimics acute coronary syndrome. Acute alcohol intoxication as a trigger for TCM has been rarely reported as TCM is usually associated with alcohol withdrawal, not intoxication. The authors report a 41-year-old woman with polysubstance and alcohol abuse history, who presented with acute alcohol intoxication and electrocardiogram demonstrating ventricular tachycardia with syncope. Laboratory parameters revealed elevated Troponin-I and metabolic acidosis. Coronary angiogram was unrevealing for coronary atherosclerosis and she was managed conservatively for acute heart failure from TCM.

scholarly journals Coronary spasm secondary to cefuroxime injection, complicated with cardiogenic shock – a manifestation of Kounis syndrome: case report and literature review

2017 ◽  
Vol 7 (7) ◽  
pp. 624-630 ◽  
Author(s):  
Andreas Mitsis ◽  
Evi Christodoulou ◽  
Panayiota Georgiou
Keyword(s):  
Case Report ◽  
Cardiogenic Shock ◽  
Coronary Artery Spasm ◽  
Coronary Spasm ◽  
Haemodynamic Effect ◽  
Atheromatous Plaque ◽  
Type I ◽  
Kounis Syndrome ◽  
Coronary Syndrome ◽  
Allergic Angina

Kounis syndrome is defined as the coincidental occurrence of an acute coronary syndrome with hypersensitivity reactions following an allergic event. The three reported variants of Kounis syndrome are vasospastic allergic angina, allergic myocardial infarction and stent thrombosis with occluding thrombus. The syndrome is caused by various inflammatory mediators. The pathophysiological characteristics of Kounis syndrome involve coronary artery spasm and/or atheromatous plaque erosion or rupture during an allergic reaction. Several causes have been described to induce Kounis syndrome, and their number is increasing rapidly. The haemodynamic effect of the syndrome complicated by cardiogenic shock seems to combine allergic shock with extensive peripheral vasodilation and myocardial suppression with the characteristics of cardiogenic shock. Treatment of Kounis syndrome is challenging because it needs management of both cardiac and allergic manifestation simultaneously. We present a case report of type I Kounis syndrome, with coronary spasm secondary to cefuroxime injection complicated with cardiogenic shock. A brief review of the literature on the various facets of this condition is also provided.

scholarly journals miRNA miRNA on the Wall, Who Is the Most Cardio-Specific of Them All? Circulating microRNAs as Potential Biomarkers in Acute Coronary Syndrome

2021 ◽  
Author(s):  
Prima Hapsari Wulandari
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Troponin T ◽  
Kidney Diseases ◽  
Cardiac Ischemia ◽  
Cardiac Biomarkers ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
Prompt Diagnosis

Abstract The severe and acute manifestation of coronary artery disease (CAD) is acute coronary syndrome (ACS); therefore, prompt diagnosis can save lives. Cardiac biomarkers that are accepted to use in evaluating ACS are creatine kinase muscle/brain subtype (CK-MB), cardiac troponin I (CTnI), or cardiac troponin T (CTnT). However, these markers have several drawbacks, such as prolonged time to rise for prompt diagnosis and elevation in patients with chronic kidney diseases (CKD). Lately, potential, novel candidates for cardiac ischemia biomarkers have been developed, one of which is micro-ribonucleic acids (miRNAs). miRNAs are potential due to their remarkable reproducibility and stability. Several miRNAs, such as, miR-1, miR-133a, miR-133b, miR-208a, miR-208b, and miR-499a, greatly rise in concentration in the plasma or serum of patients with acute cardiac ischemia, signifying their cardiac specificity and promising biomarkers in patients with ACS. This systematic review aims to elucidate the role of cardio-specific miRNA in acute myocardial ischemia (AMI) and its relationship with other cardiac biomarkers.

scholarly journals Severe Myopericarditis in Diabetic Ketoacidosis—All Troponin are Not Myocardial Infarction

2018 ◽  
Vol 11 ◽  
pp. 117954761876335 ◽  
Author(s):  
Anthony A Odubanjo ◽  
Rohini Kalisetti ◽  
Robert Adrah ◽  
Adeniyi Ajenifuja ◽  
Blessey Joseph ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
Cardiac Biomarkers ◽  
Coronary Angiogram ◽  
Elevated Troponin ◽  
Complex Dynamic ◽  
Coronary Syndrome ◽  
Uncontrolled Diabetes ◽  
Long Term Prognosis

Uncontrolled diabetes and acute coronary syndrome share a complex dynamic that results in significant ambiguity when interpreting biomarker elevations in this setting. This is concerning because myocardial infarction has been shown to be the most common cause of death in the first 24 hours of admission for uncontrolled diabetes. Literature shows that elevation in cardiac biomarkers in patients with uncontrolled diabetes could be from viral myopericarditis, although a clear clinical significance is still lacking.1 It is, however, clear that elevation in cardiac biomarkers portends a poor long-term prognosis in patients with uncontrolled diabetes mellitus. We present a rare case of myopericarditis in a middle-aged patient with uncontrolled diabetes. The patient had elevated troponin I level reaching a peak of 7.3 ng/mL with associated ST elevations on electrocardiography. Coronary angiogram was subsequently done revealing clean coronaries. To our knowledge, this is the first description of myopericarditis in uncontrolled diabetes without a known cause.

Prognostic significance of an elevated creatine kinase in the absence of an elevated troponin I during an acute coronary syndrome

2003 ◽  
Vol 92 (12) ◽  
pp. 1442-1444 ◽  
Author(s):  
Kimberly C. Yee ◽  
Debabrata Mukherjee ◽  
Dean E. Smith ◽  
Eva M. Kline-Rogers ◽  
Jianming Fang ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Creatine Kinase ◽  
Troponin I ◽  
Prognostic Significance ◽  
Elevated Troponin ◽  
Elevated Creatine Kinase ◽  
Coronary Syndrome
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