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An Unusual Case of Recurrent Hypersensitivity Reaction Associated with Kounis-Like Acute Coronary Syndrome

There have been multiple reports of allergic reactions associated with acute coronary syndromes. This has been classically described as Kounis syndrome. We present an unusual case of 70-year-old male with multiple prior hypersensitivity reactions and history of coronary artery bypass grafting who pr...

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Autores principales: Kundumadam, Shanker, Reddy, Vivek, Mallikethi Reddy, Sagar, Kathi, Pradeep, Abidov, Aiden
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5591985/
https://www.ncbi.nlm.nih.gov/pubmed/28928989
http://dx.doi.org/10.1155/2017/6421208
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author Kundumadam, Shanker
Reddy, Vivek
Mallikethi Reddy, Sagar
Kathi, Pradeep
Abidov, Aiden
author_facet Kundumadam, Shanker
Reddy, Vivek
Mallikethi Reddy, Sagar
Kathi, Pradeep
Abidov, Aiden
author_sort Kundumadam, Shanker
collection PubMed
description There have been multiple reports of allergic reactions associated with acute coronary syndromes. This has been classically described as Kounis syndrome. We present an unusual case of 70-year-old male with multiple prior hypersensitivity reactions and history of coronary artery bypass grafting who presented recurrent episode of severe angioedema and anaphylaxis. He responded to epinephrine but subsequently developed a non-ST elevation myocardial infarction with worsening heart failure. Our case is unique in that, unlike classic Kounis syndrome, the acute coronary event in this case did not present concurrently with the allergic reaction; rather it took nearly 48 hours to present. Subsequent angiogram revealed patent grafts and significant decline in the left ventricular systolic function as compared to his own ECHO a year ago. We postulate that slow mediators of inflammation may play a role in delayed development of acute coronary events with associated LV dysfunction following episodes of angioedema and anaphylaxis.
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spelling pubmed-55919852017-09-19 An Unusual Case of Recurrent Hypersensitivity Reaction Associated with Kounis-Like Acute Coronary Syndrome Kundumadam, Shanker Reddy, Vivek Mallikethi Reddy, Sagar Kathi, Pradeep Abidov, Aiden Case Rep Cardiol Case Report There have been multiple reports of allergic reactions associated with acute coronary syndromes. This has been classically described as Kounis syndrome. We present an unusual case of 70-year-old male with multiple prior hypersensitivity reactions and history of coronary artery bypass grafting who presented recurrent episode of severe angioedema and anaphylaxis. He responded to epinephrine but subsequently developed a non-ST elevation myocardial infarction with worsening heart failure. Our case is unique in that, unlike classic Kounis syndrome, the acute coronary event in this case did not present concurrently with the allergic reaction; rather it took nearly 48 hours to present. Subsequent angiogram revealed patent grafts and significant decline in the left ventricular systolic function as compared to his own ECHO a year ago. We postulate that slow mediators of inflammation may play a role in delayed development of acute coronary events with associated LV dysfunction following episodes of angioedema and anaphylaxis. Hindawi 2017 2017-08-27 /pmc/articles/PMC5591985/ /pubmed/28928989 http://dx.doi.org/10.1155/2017/6421208 Text en Copyright © 2017 Shanker Kundumadam et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kundumadam, Shanker
Reddy, Vivek
Mallikethi Reddy, Sagar
Kathi, Pradeep
Abidov, Aiden
An Unusual Case of Recurrent Hypersensitivity Reaction Associated with Kounis-Like Acute Coronary Syndrome
title An Unusual Case of Recurrent Hypersensitivity Reaction Associated with Kounis-Like Acute Coronary Syndrome
title_full An Unusual Case of Recurrent Hypersensitivity Reaction Associated with Kounis-Like Acute Coronary Syndrome
title_fullStr An Unusual Case of Recurrent Hypersensitivity Reaction Associated with Kounis-Like Acute Coronary Syndrome
title_full_unstemmed An Unusual Case of Recurrent Hypersensitivity Reaction Associated with Kounis-Like Acute Coronary Syndrome
title_short An Unusual Case of Recurrent Hypersensitivity Reaction Associated with Kounis-Like Acute Coronary Syndrome
title_sort unusual case of recurrent hypersensitivity reaction associated with kounis-like acute coronary syndrome
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5591985/
https://www.ncbi.nlm.nih.gov/pubmed/28928989
http://dx.doi.org/10.1155/2017/6421208
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