Case Report

Sudden Cardiac Arrest Associated With Widespread Coronary Vasospasm After Oral Amoxicillin/Clavulanic Acid Intake (A Rare Case Of Kounis Syndrome)

Volume: 6 Number: 1 January 31, 2025
EN TR

Sudden Cardiac Arrest Associated With Widespread Coronary Vasospasm After Oral Amoxicillin/Clavulanic Acid Intake (A Rare Case Of Kounis Syndrome)

Abstract

Kounis syndrome is known as a type of acute coronary syndrome that occurs secondary to hypersensitivity reactions and constitutes a life-threatening medical emergency. Although multiple etiologies of KS have been elucidated, pharmacological agents are the most prevalent. Antimicrobial agents and nonsteroidal anti-inflammatory drugs (NSAIDs) are the most frequently utilized medications. KS is not rare, and its frequency has been reported to increase since it was first described in 1950. However, it is often underdiagnosed owing to its wide range of clinical manifestations. Diagnostic evaluation should encompass laboratory, electrocardiographic, echocardiographic, and angiographic evidence in addition to clinical symptoms and signs. In this case study, we presented a 56 year old patient without any chronic disease who presented with sudden cardiac arrest after taking oral amoxicillin/clavulanic acid.

Keywords

Oral antibiotics , cardiac arrest , coronary vasospasm , Kounis Syndrome

References

  1. 1. Kounis NG. Kounis syndrome: An update on epidemiology, pathogenesis, diagnosis and therapeutic management. Clin Chem Lab Med. 2016 Oct 1;54(10):1545–59.
  2. 2. Poggiali E, Benedetti I, Vertemati V, Rossi L, Monello A, Giovini M, et al. Kounis syndrome: from an unexpected case in the Emergency Room to a review of the literature. Acta Biomed. 2022 Mar 14 ;93(1).
  3. 3. R Desai, T Parekh, U Patel, HK Fong, S Samani, C Patel, et al. Epidemiology of acute coronary syndrome co-existent with allergic/hypersensitivity/anaphylactic reactions (Kounis syndrome) in the United States: A nationwide inpatient analysis. Int J Cardiol 2019 Oct 1:292:35-38.
  4. 4. Ollo-Morales P, Gutierrez-Niso M, De-La-Viuda-Camino E, Ruiz-De-Galarreta-Beristain M, Osaba-Ruiz-De-Alegria I, et al. Drug-Induced kounis syndrome: latest novelties. Curr Treat Options Allergy 2023 Sep 1; 10(3):301–18.
  5. 5. Nanyoshi M, Hayashi T, Sugimoto R, Nishisaki H, Kenzaka T. Type I Kounis syndrome in a young woman without chest pain: a case report. BMC Cardiovasc Disord. 2024 Dec 1; 24(1):1–7.
  6. 6. Pejcic A V., Milosavljevic MN, Jankovic S, Davidovic G, Folic MM, Folic ND. Kounis Syndrome Associated With the Use of Diclofenac. Tex Heart Inst J. 2023 Jan 1; 50(1).
  7. 7. Moloney N, Paget S, Keijzers G. Kounis syndrome: Anaphylaxis causing coronary occlusion. Emerg Med Australas. 2019 Oct 1; 31(5):903–5.
  8. 8. Ralapanawa DMPUK, Kularatne SAM. Kounis syndrome secondary to amoxicillin/clavulanic acid administration: a case report and review of literature. BMC Res Notes. 2015 Mar 26; 8(1).
  9. 9. Calogiuri G, Savage MP, Congedo M, Nettis E, Mirizzi AM, Foti C, et al. Is Adrenaline Always the First Choice Therapy of Anaphylaxis? An Allergist-cardiologist Interdisciplinary Point of View. Curr Pharm Des. 2023 Oct 25; 29(32):2545–51.
  10. 10. Yakushin S, Gurbanova A, Pereverzeva K. Kounis Syndrome: Review of Clinical Cases. Cardiovasc Hematol Disord Drug Targets. 2024 Jul 18; 24(2):83–97.
APA
Kertmen, Ö., & Çakmak, A. (2025). Sudden Cardiac Arrest Associated With Widespread Coronary Vasospasm After Oral Amoxicillin/Clavulanic Acid Intake (A Rare Case Of Kounis Syndrome). Archives of Current Medical Research, 6(1), 66-70. https://doi.org/10.47482/acmr.1605130