scholarly journals Amoxicillin/clavulanate allergic reaction, implantable defibrillator shock and Kounis syndrome: Pathophysiologic considerations

Author(s):  
Nicholas G Kounis
2019 ◽  
Vol 72 (1) ◽  
pp. 137-141
Author(s):  
Olga Wajtryt ◽  
Tadeusz M Zielonka ◽  
Aleksandra Kaszyńska ◽  
Andrzej Falkowski ◽  
Katarzyna Życińska

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.


2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
D. Forlani ◽  
G. Scarano ◽  
A. D’Alleva ◽  
M. Di Marco ◽  
L. Paloscia ◽  
...  

Mast cells are abundant in the heart, among myocardial fibers, around coronary arteries, within arterial intima and intramural vessels, and in atherosclerotic plaques. Their mediators can be released during anaphylaxis and be responsible for acute coronary syndrome. This condition has been described as Kounis syndrome (KS). We report three cases of acute myocardial ischemia, which fulfill the definition for KS. In Cases 1 and 2, the association of intense chest pain with acute urticaria after an allergenic contact (wasp sting and betalactam antibiotic administration, respectively) was suspected to be an attack of angina related to an allergic reaction. No signs of an allergic reaction were observed in Case 3, but only the history of a wasp sting suggested its relationship to loss of consciousness and heart ischemia when hypersensitivity to venom was ascertained. These cases strongly recommend measurement of anaphylactic biomarkers, such as tryptase, during acute coronary syndromes to detect the possible involvement of an allergic reaction. Conversely, measurement of cardiac biomarkers during anaphylaxis, even without obvious signs of myocardial ischemia, might identify patients at risk of myocardial injury.


2010 ◽  
Vol 25 (3) ◽  
pp. 263-266 ◽  
Author(s):  
Tadashi Wada ◽  
Mitsuru Abe ◽  
Nobuhito Yagi ◽  
Nobuaki Kokubu ◽  
Yoichiro Kasahara ◽  
...  

2010 ◽  
Vol 139 (2) ◽  
pp. 206-209 ◽  
Author(s):  
John S. Kogias ◽  
Emmanouil X. Papadakis ◽  
Constantinos G. Tsatiris ◽  
George Hahalis ◽  
George N. Kounis ◽  
...  

2021 ◽  
Vol 19 (2) ◽  
pp. 229-235
Author(s):  
L. V. Kalatsei ◽  
◽  
V. A. Snezhitskiy ◽  
S. N. Hrib ◽  
T. G. Liskovich ◽  
...  

Kounis syndrome is one of the rare variants of acute coronary syndrome that occurs as a result of an allergic reaction. Its main pathophysiological mechanism is coronary vasospasm. Clinically, Kounis syndrome is manifested by symptoms of both an allergic reaction and an acute coronary syndrome, and its treatment is not an easy task, since both cardiac and allergic manifestations must be treated at the same time. In the given article we describe a clinical case of diagnosis and successful treatment of Kounis syndrome caused by cold urticaria in a 58-year-old patient who was hospitalized to the Grodno Regional Clinical Cardiology Center.


2012 ◽  
Vol 159 (2) ◽  
pp. e27-e28 ◽  
Author(s):  
Uğur Canpolat ◽  
Levent Şahiner ◽  
Kudret Aytemir ◽  
Ali Oto

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Metin Çeliker ◽  
Mustafa Tuncer ◽  
Ali Şekeralmaz

Allergic reaction-associated acute coronary syndrome picture is defined as Kounis syndrome. Although drug use is the most common cause of allergic reaction, foods and environmental factors may also play a role in the etiology. Herein, a case with acute coronary syndrome that developed two times at 8-month interval due to pseudoephedrine use for upper respiratory tract infection is presented.


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