Management of Kounis syndrome: two case reports

Journal of Medical Case Reports
Majdi OmriNaoufel Chebili

Abstract

Kounis syndrome corresponds to the occurrence of myocardial injury following an allergic insult. This syndrome is infrequent, and is not well known. In consequence, it is usually misdiagnosed leading to inappropriate treatment. The current literature is limited to case studies and there are no international recommendations concerning this topic. We discussed, through two case reports, the clinical presentation and the management of a 60-year-old North African man and a 45-year-old North African man presenting with chest pain suggesting acute coronary syndrome following anaphylactic reaction. Triggering factors were a drug in the first case and herbal dermal exposure in the second. A clinical examination and electrocardiogram revealed anaphylactic reaction associated with myocardial infarction. Appropriate management of these two life-threatening conditions allowed an improvement in our patients' condition and their transfer to specialized units. Although Kounis syndrome is a rare phenomenon, physicians should be aware of its physiopathological mechanisms in order to treat it appropriately. The difficulty lies in the fact that the treatment of either of the two associated entities may worsen the other injury.

References

Oct 27, 2005·International Journal of Cardiology·Nicholas G Kounis
Mar 9, 2010·International Journal of Cardiology·Cihan CevikNicholas G Kounis
Jan 23, 2016·European Journal of Internal Medicine·Filippo FassioEnrico Heffler
Aug 14, 2015·Journal of Cardiology Cases·Shozo SuedaHiroaki Kohno

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Citations

Nov 15, 2019·Critical Care Medicine·Cristina GutierrezStephen M Pastores
Sep 26, 2020·European Heart Journal. Case Reports·Anthony MattaJerome Roncalli

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