Intraoperative Cardiac Arrest due to Allergic Acute Coronary Syndrome (Kounis syndrome) Triggered by Cephalosporin

Background: Kounis syndrome is defined as a combination of acute coronary syndrome and allergic reactions. Objective: In this review, we aim to describe the etiological, clinical, and diagnostic characteristics of Kounis syndrome. Methods: A literature search using PubMed was conducted for the past 32 years using keywords, resulting in the selection of 761 scientific papers. From these, 217 articles describing 235 clinical cases were selected. Patients under 18 years of age or without a confirmed diagnosis were excluded. Results: Among the 235 patients, type I Kounis syndrome was observed in 49.7%, type II in 27.2%, type III in 5.9%, and a combination of types I and II in 1.0%; in 16.2%, it was not possible to classify the type of Kounis syndrome. The median age was 57 years, and 68.5% of the patients were male. The most common causes were antibiotics (32.3%) and non-steroidal anti-inflammatory drugs (24.3%). The clinical features included chest pain (59.1%), hypotension (74.2%), itching (30.6%), and dyspnea (30.6%). Electrocardiographic monitoring revealed ST-segment elevation in 42.9% and was normal in only 5.5% of patients. Coronary angiography was performed in 80.4% of the patients, revealing unchanged coronary arteries in 50.3% of cases. Сonclusion: Allergic myocardial infarction is a serious complication of drug therapy

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A Report of a Rare Case of Kounis Syndrome in a Patient With HIV/AIDS and Mpox

Jha,

Aryal

et al. 2024

Cureus

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Kounis syndrome (KS) is defined as the occurrence of acute coronary syndrome due to coronary artery spasm in a patient with an allergic reaction. Antibiotics are the most common trigger for KS. In this case report, we present a 45-year-old man with HIV/AIDS who was being managed for mpox and developed chest pain and hypotension during vancomycin infusion, which was complicated by the development of ST-elevation myocardial infarction (STEMI). His left heart catheterization showed normal coronaries with the resolution of ECG changes and symptoms upon discontinuing vancomycin.

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Intraoperative Cardiac Arrest due to Allergic Acute Coronary Syndrome (Kounis syndrome) Triggered by Cephalosporin

Cited by 3 publications

References 15 publications

Cefuroxime/Epinephrine

Cefuroxime/Epinephrine

Kounis Syndrome: Review of Clinical Cases

A Report of a Rare Case of Kounis Syndrome in a Patient With HIV/AIDS and Mpox

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