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CC BY-NC-ND 4.0 · Avicenna J Med 2018; 8(01): 37-39
DOI: 10.4103/ajm.AJM_114_17
CASE REPORT

Type I Kounis syndrome variant: A case report and literature review

Abdullah Haddad
Department of Internal Medicine, Saint Clair Memorial Hospital, Allegheny General Hospital, Pittsburgh, PA, USA
,
Triston Smith
Department of Internal Medicine, Saint Clair Memorial Hospital, Allegheny General Hospital, Pittsburgh, PA, USA
,
Aneel Bole
Department of Internal Medicine, Saint Clair Memorial Hospital, Allegheny General Hospital, Pittsburgh, PA, USA
,
Moneal Shah
Department of Internal Medicine, Saint Clair Memorial Hospital, Allegheny General Hospital, Pittsburgh, PA, USA
,
Mithun Chakravarthy
Department of Internal Medicine, Saint Clair Memorial Hospital, Allegheny General Hospital, Pittsburgh, PA, USA
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Kounis syndrome defined as the occurrence of acute coronary syndrome in the setting of allergic reaction due to mast cells activation and inflammatory mediators release that induces coronary vasospasm, plaque erosion, or even stent thrombosis. A 25-year-old postpartum female with asthma and recurrent episodes of chest pain was admitted with ST-segment elevation myocardial infarction in the setting of coronary artery spasms. The patient was started on calcium channel blockers and nitrite-based medication with no improvement. She was noted to have eosinophilia and initiation of corticosteroid-based regimen lead to resolution of chest pain episodes and normalization of eosinophilia. Kounis syndrome should be considered in young patients with chest pain. Coronary vasodilators are considered as the first-line of treatment. The use of corticosteroids has been described in the literature in severe or refractory cases.

Keywords

Allergic coronary artery syndrome - coronary artery vasospasm - Kounis syndrome


Publication History

Article published online:
12 August 2021

© 2018. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Kounis NG. Coronary hypersensitivity disorder: The Kounis syndrome. Clin Ther 2013; 35: 563-71
    CrossrefPubMedGoogle Scholar
  • 2 Kounis NG, Mazarakis A, Tsigkas G, Giannopoulos S, Goudevenos J. Kounis syndrome: A new twist on an old disease. Future Cardiol 2011; 7: 805-24
    CrossrefPubMedGoogle Scholar
  • 3 Kounis NG. Kounis syndrome (allergic angina and allergic myocardial infarction): A natural paradigm? Int J Cardiol 2006; 110: 7-14
    PubMed
  • 4 Umemoto S, Suzuki N, Fujii K, Fujii A, Fujii T, Iwami T. et al. Eosinophil counts and plasma fibrinogen in patients with vasospastic angina pectoris. Am J Cardiol 2000; 85: 715-9
    CrossrefPubMedGoogle Scholar
  • 5 Cevik C, Nugent K, Shome GP, Kounis NG. Treatment of Kounis syndrome. Int J Cardiol 2010; 143: 223-6
    CrossrefPubMedGoogle Scholar
  • 6 Steffel J, Akhmedov A, Greutert H, Lüscher TF, Tanner FC. Histamine induces tissue factor expression: Implications for acute coronary syndromes. Circulation 2005; 112: 341-9
    CrossrefPubMedGoogle Scholar
  • 7 Ralapanawa DM, Kularatne SA. A case of kounis syndrome after a hornet sting and literature review. BMC Res Notes 2014; 7: 867
    CrossrefPubMedGoogle Scholar
  • 8 Takagi S, Goto Y, Hirose E, Terashima M, Sakuragi S, Suzuki S. et al. Successful treatment of refractory vasospastic angina with corticosteroids: Coronary arterial hyperactivity caused by local inflammation. Circ J 2004; 68: 17-22
    CrossrefPubMedGoogle Scholar
  • 9 Wong CW, Luis S, Zeng I, Stewart RA. Eosinophilia and coronary artery vasospasm. Heart Lung Circ 2008; 17: 488-96
    CrossrefPubMedGoogle Scholar