KOUNIS SYNDROME or ADRENALİN SIDE-EFFECT?

Abstract

Objective: Kounis syndrome is defined as acute coronary syndrome secondary to a hypersensitivity reaction. Detailed assessment should be taken during treating this syndrome, as coronary vasospasm may develop secondary to anti-allergic drugs. We report a case of myocardial infarction where the effects of adrenaline are intertwined with Kounis syndrome. Case Report: A 66-year-old male patient was brought to the emergency department with a bee sting. Adrenaline was administered in the ambulance because syncope developed. ECG diagnosed inferior myocardial infarction. Results and Conclusion: This syndrome warrants close attention due to coronary vasospasm risk caused by anti-allergy agents, as they can exacerbate a concurrent myocardial infarction.

Keywords

• Kounis Syndrome
• Adrenaline
• Side-effect
• Myocardial infarction
• Anti-allergy

References

1. Referans1. Kounis NG, Zavras GM. Histamine-induced coronary artery spasm: the concept of allergic angina. The British journal of clinical practice. 1991; 45(2), 121-128.
2. Referans2. Constantinides P, Harkey M. Electron microscopic exploration of human endothelium in step-serial sections of early and advanced atherosclerotic lesions. Annals of the New York Academy of Sciences. 1990; 598, 113-124.
3. Referans3. Gonzalez-de-Olano D, Alvarez-Twose I, Matito A, Sanchez-Munoz L, Kounis NG, Escribano L. Mast cell activation disorders presenting with cerebral vasospasm-related symptoms: a" Kounis-like" syndrome? International journal of cardiology. 2011; 150(2), 210-211.
4. Referans4. Nikolaidis LA, Kounis NG, Gradman AH. Allergic angina and allergic myocardial infarction: a new twist on an old syndrome. The Canadian journal of cardiology. 2002; 18(5), 508-511.
5. Referans5. Bonadonna P, Perbellini O, Passalacqua G, Caruso B, Colarossi S, Dal Fior D, et.al. Clonal mast cell disorders in patients with systemic reactions to Hymenoptera stings and increased serum tryptase levels. Journal of allergy and clinical immunology. 2009; 123(3), 680-686.
6. Referans6. Mytas DZ, Stougiannos PN, Zairis MN, Tsiaousis GZ, Foussas SG, Hahalis GN, et.al. Acute anterior myocardial infarction after multiple bee stings. A case of Kounis syndrome. International Journal of Cardiology. 2009; 134(3), e129-e131.
7. Referans7. Bertel O, Buhler FR, Baitsch G, Ritz R, Burkart F. Plasma adrenaline and noradrenaline in patients with acute myocardial infarction: relationship to ventricular arrhythmias of varying severity. Chest. 1982; 82(1), 64-68.