scholarly journals Intraoperative Anaphylactic Shock Following Cefuroxime-Axetil Routine Test Case report and literature review

2019 ◽  
Vol 70 (3) ◽  
pp. 925-928
Author(s):  
Mirela Tiglis ◽  
Andreea Mester ◽  
Tudor Hurmuzache ◽  
Camelia Cristina Diaconu ◽  
Razvan Ion Florin Dragomirescu ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Anaphylactic Shock ◽  
Perioperative Period ◽  
Cefuroxime Axetil ◽  
Test Case ◽  
Allergic Reactions ◽  
Routine Test ◽  
Kounis Syndrome ◽  
Coronary Syndrome ◽  
Cardio Vascular

Approximately 72% of patients with anaphylaxis present cardio-vascular manifestations, with only few reported cases of cardiogenic shock and cardiac arrest. Cephalosporins are the most used antibiotics for prophylaxis in the perioperative period with a prevalence of allergic reactions between 1-3%. Cefuroxime, a second-generation semisynthetic cephalosporin, presents relatively rare anaphylactic reactions (0.015%). Kounis syndrome is characterized by appearance of acute coronary syndrome in the presence of platelets, basophils or mast cells activation, due to an allergic reaction, hypersensitivity, anaphylactic reaction or shock. We report a rare case of a 53-year-old female patient with intraoperative anaphylactic shock following Cefuroxime-axetil routine test, complicated with Kounis syndrome and finally with cardiac arrest.

scholarly journals Two Cardiac Arrests that Occurred after the Administration of Sugammadex: A Case of Kounis Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Machi Yanai ◽  
Koichi Ariyoshi
Keyword(s):  
Cardiac Arrest ◽  
Elevated Serum ◽  
Allergic Reactions ◽  
Kounis Syndrome ◽  
Coronary Syndrome ◽  
Allergy Test ◽  
Skin Allergy ◽  
Neck Fracture ◽  
Serum Trypsin ◽  
Distal Fracture

Kounis syndrome is a form of acute coronary syndrome caused by allergic reactions. No cases of cardiac arrest caused by Kounis syndrome that arose after the administration of sugammadex have been reported. A 71-year-old female suffered two cardiac arrests. The first occurred after sugammadex was administered at the end of an operation for a right radial distal fracture. The patient was resuscitated and transferred to our intensive care unit. She was subsequently discharged home. Five months later, she suffered a second cardiac arrest after sugammadex was administered at the end of an operation for a right femoral neck fracture at our hospital. Urgent coronary angiography revealed multiple coronary spasms. Kounis syndrome was diagnosed based on the patient’s elevated serum trypsin levels and a positive result in a skin allergy test of sugammadex. In cases of cardiac arrest with unclear etiologies, Kounis syndrome should be considered.

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.

An unusual case of concurrent Kounis syndrome and prolonged QT in a young patient

2021 ◽  
pp. 1-3
Author(s):  
Emrah Erdogan ◽  
Murat Cap ◽  
Gorkem Kus ◽  
Cem Gokhan ◽  
Yakup Kilic
Keyword(s):  
Acute Coronary Syndrome ◽  
Young Patient ◽  
Unusual Case ◽  
Allergic Reactions ◽  
Kounis Syndrome ◽  
Unique Case ◽  
Coronary Syndrome ◽  
Life Threatening ◽  
Anaphylactoid Reactions ◽  
Prolonged Qt

Abstract Allergic reactions related to drug use is a common entity presenting often from minor urticaria to life-threatening anaphylactoid reactions. A common but easily overlooked diagnosis, Kounis syndrome, is an established hypersensitivity coronary disorder induced by drugs, foods, environmental factors, and coronary stents that can present in the same way as non-allergy-induced acute coronary syndrome. Here within, we present a unique case of dual presentation of Kounis syndrome and prolonged QTc in a young patient after a single dose of Domperidone and Lansoprazole.

scholarly journals Acute Coronary Syndrome in Cisatracurium-induced Anaphylactic Shock: Kounis Syndrome

2008 ◽  
Vol 46 (4) ◽  
pp. 184-186 ◽  
Author(s):  
Ya-Ling Yang ◽  
Hui-Wen Huang ◽  
Hon-Kan Yip ◽  
Bruno Jawan ◽  
Chia-Chih Tseng ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Anaphylactic Shock ◽  
Kounis Syndrome ◽  
Coronary Syndrome

scholarly journals Contrast Media Induced Kounis Syndrome: A Case Report

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 154
Author(s):  
Da-Sen Chien ◽  
Andy Po-Yi Tsai ◽  
Po-Chen Lin ◽  
Giou-Teng Yiang ◽  
Meng-Yu Wu
Keyword(s):  
Blood Pressure ◽  
Cardiac Arrest ◽  
Contrast Media ◽  
Cardiac Dysfunction ◽  
Plaque Rupture ◽  
Coronary Spasm ◽  
Allergic Reactions ◽  
Timely Manner ◽  
Kounis Syndrome ◽  
Accompanying Symptoms

Kounis syndrome is a rare anaphylactic reaction leading to coronary spasm, acute plaque rupture, or intrastent stenosis. Many types of medicine or environmental factors can potentially trigger Kounis syndrome by mast cell allergic reactions. In severe Kounis syndrome, reduced blood pressure or cardiac arrest may be accompanying symptoms. The treatment strategy for Kounis syndrome is usually difficult due to both cardiac dysfunction and allergic reactions. The delay to intervention to break the vicious circle may cause catastrophic complications. Therefore, early diagnosis is critical for physicians to outline detailed etiology for prevention and treat the cardiac and allergic symptoms in a timely manner. Here, we describe a case presenting rare severe Kounis syndrome with cardiac arrest which occurred after the administration of a contrast media.

scholarly journals Kounis syndrome secondary to nimesulide ingestion: a case report

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Yamasandi Siddegowda Shrimanth ◽  
Krishna Santosh Vemuri ◽  
Atit A. Gawalkar ◽  
Soumitra Ghosh ◽  
Jyothi Vijay ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hypersensitivity Reaction ◽  
Regional Wall Motion ◽  
Maculopapular Rash ◽  
Coronary Intervention ◽  
Cardiac Biomarkers ◽  
Drug Eluting Stent ◽  
Allergic Reactions ◽  
Kounis Syndrome ◽  
Coronary Syndrome

Abstract Background Kounis syndrome, also known as "allergic myocardial infarction," is a rare co-occurrence of acute coronary syndrome (ACS) in the setting of hypersensitivity reaction to any agent. Non-steroidal anti-inflammatory drugs (NSAIDs) like are often implicated in causing allergic reactions. Here, we present a case of anterior wall myocardial infarction (AWMI) occurred following angioedema secondary to intake of Nimesulide, not described earlier in literature. Case presentation A 45-year-old female developed generalized pruritic, erythematous maculopapular rash, facial puffiness, oral ulcers and hoarseness of voice within few hours following consumption of Nimesulide for fever and body-ache. Due to development of hypotension, electrocardiogram (ECG) was done, which revealed ST elevation in V2–V6, with marked elevation of troponin (TnI) and creatine kinase (CK-MB). He had no chest pain or shortness of breath. Echocardiography showed regional wall motion (RWMA) abnormality in left anterior descending artery (LAD) territory with an ejection fraction of 25%. Coronary angiography showed a complete thrombotic cutoff of LAD, for which Tirofiban infusion was started to decrease thrombus burden. Repeat angiography on next day showed 80% lesion in proximal LAD for which she underwent revascularization with a drug-eluting stent. The patient later showed improvement in cardiac function at 8 months of follow-up. Conclusions The occurrence of ACS requiring percutaneous coronary intervention (PCI) in the setting of allergic reactions is rarely reported in the literature. One should be aware of the rare possibility of Kounis syndrome in the setting of hypersensitivity reaction when accompanying features of symptoms suggestive of coronary artery disease co-exists. When indicated, ECG monitoring and cardiac biomarkers in patients with allergic responses help to identify this rare and treatable condition.

Peculiarities of the course of type I allergic reactions in patients with blood diseases

2020 ◽  
pp. 40-50
Author(s):  
A. Nikitina
Keyword(s):  
Search Engines ◽  
Anaphylactic Shock ◽  
Type I ◽  
Allergic Reactions ◽  
Common Cause ◽  
Blood Diseases ◽  
Treatment Regimens ◽  
Modern Methods

Analysis of literature data presented in search engines — Elibrary, PubMed, Cochrane — concerning the risk of developing type I allergic reactions in patients with blood diseases is presented. It is shown that the most common cause of type I allergic reactions is drugs included in the treatment regimens of this category of patients. The article presents statistics on the increase in the number of drug allergies leading to cases of anaphylactic shock in patients with blood diseases. Modern methods for the diagnosis of type I allergic reactions in vivo and in vitro are considered.

Abstract 11324: Immediate Percutaneous Coronary Intervention in Patients with Refractory Out of Hospital Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Daniel Rob ◽  
Jana Smalcova ◽  
Tomas Kovarnik ◽  
David Zemanek ◽  
Ales Kral ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Arrest ◽  
Lower Risk ◽  
Coronary Intervention ◽  
Post Hoc Analysis ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Post Hoc ◽  
Hospital Cardiac Arrest

Background: An increasing number of cardiac centres are using immediate percutaneous coronary intervention (PCI) and extracorporeal cardiopulmonary resuscitation (ECPR) in patients with refractory out of hospital cardiac arrest (r-OHCA). Published evidence regarding PCI in OHCA has been mainly reporting to patients with early return of spontaneous circulation and the influence of PCI and ECPR on survival in the population of patients with r-OHCA and acute coronary syndrome (ACS) remains unclear. Methods: In this post hoc analysis of the randomized r-OHCA trial, all patients with ACS as a cause of r-OHCA were included. The effect of successful PCI and ECPR on 180-days survival was examined using Kaplan-Meier estimates and multivariable Cox regression. Results: In total, 256 patients were evaluated in Prague OHCA study and 127 (49.6 %) had ACS as the cause of r-OHCA constituting current study population. The mean age was 58 years (46.3-64) and duration of resuscitation was 52.5 minutes (36.5-68). ECPR was used in 51 (40.2 %) of patients. Immediate PCI was performed in 86 (67.7%) patients and TIMI flow 2 or 3 was achieved in 75 (87.2%) patients. The overall 180-days survival of patients with successful PCI was 40 % compared to 7.7 % with no or failed immediate PCI (log-rank p < 0.001). After adjustment for confounders, successful PCI was associated with a lower risk of death (HR 0.47, CI 0.24-0.93, p = 0.031). Likewise, ECPR was associated with a lower risk of death (HR 0.11, CI 0.05-0.24, p< 0.001). Conclusion: In this post hoc analysis of the randomized r-OHCA trial, successful immediate PCI as well as ECPR were associated with improved 180-days survival in patients with r-OHCA due to ACS.

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