Arı Sokmasına Bağlı Genç Hastada Kounis Sendromu: Olgu Sunumu

Öz

Böcek sokmaları hipersensivite reaksiyonu ile basit bir ürtikerden miyokard infarktüsüne kadar gidebilen değişik klinik durumlara sebeb olmaktadır. Böcek sokmalarının neden olduğu akut koroner sendromlara Kounis sendromu denmektedir. Miyokard infarktüsü (Mİ) tüm dünyadaki mortalite ve morbiditenin en yaygın sebeplerinden biridir. Kırk üç yaşında erkek hasta arı sokmasını takiben şiddetli göğüs ağrısı yakınması ile acil servise başvurdu. Fizik muayenesinde kan basıncı 85/50 mm/Hg, nabız 60/dk idi. Hastanın çekilen EKG’sinde anterior derivasyonlarda (V1-V6) belirgin ST yükselmesi mevcuttu. Antihistaminik ve steroid tedavisinden 15 dakika sonra çekilen EKG’de anterior derivasyonlardaki ST segment elevasyonlarının gerilediği tespit edildi. Akut anterior MI tanısı ile kateter laboratuarına alınan hastada sol ön inen arter (LAD) proksimalinde %80 lezyon tespit edildi. Sonuç olarak arı sokması sonrasında acil servise başvuran hastalarda Kounis sendromunun da göz önünde bulundurularak antihistaminik ve steroid grubu ilaçların kullanılması düşünülmelidir.

Anahtar Kelimeler

• Akut koroner sendrom, böcek ısırığı, allerjik reaksiyon

Kounis Syndrome in a Young Patient After Bee Sting: Case Report

Öz

Hypersensitivity reactions due to insect bites cause different clinical situations ranging from simple urticaria to myocardial infarction. Acute coronary syndrome caused by insect bites is called Kounis syndrome. Myocardial infarction (MI) is one of the most common causes of mortality and morbidity in the world. Following a bee sting, a 43-year-old male patient was admitted to the emergency room with severe chest pain. Upon physical examination of the patient, blood pressure was 85/50 mm/Hg, heart rate was 60 beats/minute and respiratory rate was 12/minute. The ECG of the patient showed a significant ST elevation in anterior derivations. Treatment was started with intravenous antihistamines and steroids. After fifteen minutes, decreased ST segment elevation in anterior derivations were detected on the ECG of patient. Coronary angiography revealed 80% stenosis in the left anterior descending artery (LAD). As a result, we suggest that emergency room physicians should consider the use of antihistamines and steroids in with to bee stings in Kounis syndrome patients

Anahtar Kelimeler

• Acute coronary syndrome, insect bites, allergic reaction

Kaynakça

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