Type III Kounis Syndrome Caused by Iodine Contrast Media After Improvement of Allergic Symptoms.

Autor:	Okuda R; Emergency and Critical Care Center, Kagoshima City Hospital, Kagoshima, JPN.; Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JPN., Utsumi S; Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN., Tanaka H; Cardiology, National Hospital Organization Kagoshima Medical Center, Kagoshima, JPN., Takama T; Emergency and Critical Care Center, Kagoshima City Hospital, Kagoshima, JPN.; Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JPN., Kakihana Y; Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JPN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Mar 04; Vol. 16 (3), pp. e55514. Date of Electronic Publication: 2024 Mar 04 (Print Publication: 2024).
DOI:	10.7759/cureus.55514
Abstrakt:	Kounis syndrome is an acute coronary syndrome (ACS) caused by an allergic reaction that almost always occurs immediately and simultaneously with allergic symptoms. We present a case of Kounis syndrome type III that developed after complete resolution of contrast-induced anaphylaxis in a 60-year-old man with a coronary stent placed in the proximal left anterior descending (LAD) artery branch for ischemic heart disease. Contrast-enhanced computed tomography revealed anaphylactic shock. Symptoms quickly improved with intramuscular adrenaline injection; however, chest pain appeared after approximately 30 min. ECG revealed ST-wave elevation in the precordial leads. Coronary angiography revealed acute stent thrombosis with total occlusion of the proximal LAD, and percutaneous coronary angioplasty was performed. We diagnosed Kounis syndrome based on the allergic symptoms and ACS. Because some cases of Kounis syndrome develop after anaphylactic symptoms have resolved, it is advisable to follow-up patients with allergic symptoms and pay attention to chest symptoms and ECG changes, especially when they have a history of noted or treated coronary artery disease. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Okuda et al.)
Databáze:	MEDLINE
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