A forgotten cause of myocardial infarction in an octogenarian patient: Type 1 Kounis Syndrome

Yıl 2019, , 165 - 167, 30.12.2019

Tarık Yıldırım , Seda Elcim Yildirim

https://doi.org/10.33716/bmedj.599198

Cited By: 1

Öz

A non-steroidal antiinflammatory drug, diclofenac sodium, was initiated
to 81 year-old male patient for his knee pain by a general practitioner. After
30 minutes of ingestion of 100 mg diclofenac sodium, severe chest pain and
generalized erythema had started and he was brought to our emergency department
by the ambulance staff. Owing to the chest pain , an ECG was performed and it
revealed 2-3 mm ST segment elevation in DII-DIII and aVF leads and reciprocal
changes in other leads (Figure 1A). Immediately the patient underwent to
catheter laboratory and the coronary angiogram showed normal coronary arteries
without any obstruction (Figure 2,3). Then Kounis Type 1 was diagnosed and
intravenous antihistaminic and 40 mg of prednisolone was administered. The
patient was discharged on the second day. Our case is an example of type 1
Kounis syndrome in an octogenarian patient which we should keep in mind.

Anahtar Kelimeler

Kounis syndrome, diclofenac

Destekleyen Kurum

none

Proje Numarası

none

Yaşlı hastada miyokart infarktüsünün nadir bir nedeni: Tip 1 Kounis sendromu

Öz

81 yaş erkek hastaya,
aile hekimi tarafından, diz ağrısı nedeni ile, nonsteroid antiinflamatuar bir ilaç
olan dikolefanak sodium başlanmış. 100 mg diklofenak sodium intramuskuler
verildikten 30 dakika sonar şiddetli göğüs ağrısı ve jeneralize eritem başlayan
hasta ambulansla acil servise getirildi. Göğüsağrı nedeniyle çekilen EKG’de,
D2, D3 aVF leadlerinde 2-3 mm ST elevasyonu diğer leadlerde resiprokal
değişiklikler saptandı (Figure 1). Acil olarak katater labaratuarına alınan
hastaya yapılan koroner anjiografide koroner arterlerin normal olduğu tespit
edildi (Figure 2,3). Sonrasında Tip 1 Kounis tansı konulup intravenöz
antihistaminik ve 40 mg prednizolon uygulandı. Hasta 2. gün taburcu edildi.
Yaşlı hastalarda da tip 1 Kounis sendromu olabileceğini akılda tutmamız
gerekir.

Anahtar Kelimeler

Kounis sendromu, Diklofenak

Proje Numarası

none

Kaynakça

• 1- Kounis NG. Kounis syndrome: an update on epidemiology, pathogenesis, diagnosis and therapeutic management. Clin Chem Lab Med. 2016;54(10):1545-59.