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

Year 2025, Volume: 6 Issue: 1, 66 - 70, 31.01.2025

Ömer Kertmen , Abdulkadir Çakmak

https://doi.org/10.47482/acmr.1605130

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

Oral Amoksisilin/Klavulanik Asit Alımı Sonrası Gelişen Yaygın Koroner Vazospazm İlişkili Ani Kardiyak Arrest (Nadir Görülen Bir Kounis Sendromu Vakası)

Abstract

Kounis sendromu (KS), aşırı duyarlılık reaksiyonlarına sekonder oluşan, yaşamı tehdit eden, tıbbi bir acil durum oluşturan akut koroner sendrom olarak tanımlanır. Üç varyantı vardır: vazospastik alerjik angina (tip I), alerjik miyokard enfarktüsü (tip II) ve stent trombozu (tip III). KS için birden fazla neden tanımlanmış olsa da, ilaçlar en sık nedendir. Antibiyotikler ve NSAID'ler en sık suçlanan ilaçlardır. KS nadir değildir; ilk kez tanımlandığı 1950 yılından itibaren sıklığında artış bildirilmektedir. Ancak geniş klinik belirtileri nedeniyle sıklıkla teşhis edilememektedir. Tanı, kardiyovasküler ve alerjik/anafilaktik klinik semptom ve bulguların kombinasyonuna ek olarak laboratuvar, elektrokardiyografik, ekokardiyografik ve anjiyografik kanıtlara dayanmalıdır. Ancak şu an tedavi klinisyenler için gerçekten güçtür çünkü henüz tanı-tedavi kılavuzları oluşturulamamıştır ve tedavi varyant tipine göre yapılmaktadır. Biz de bu yazımızda, herhangi bir kronik hastalığı olmayan, oral amoksisilin/klavulanik asit kullanımı sonrası ani kardiyak arrest gelişen 56 yaşında bir hasta sunduk.

Keywords

Oral antibiyotik kullanımı, Kardiyak arrest, koroner vazospazm, Kounis Sendromu

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