Arı Sokmasına Bağlı Genç Hastada Kounis Sendromu: Olgu Sunumu

Yıl 2013, Cilt: 4 Sayı: 3, 103 - 105, 01.07.2013

Murat Ayan Hasan Kadı Mehmet Esen Kerem Özbek

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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