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Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma

A 12-year-old male patient suffering from congenital glaucoma developed bradycardia, left ventricular failure, and hypotension after induction of anesthesia. Electrocardiography and echocardiography revealed a complete normalization of ECG and a complete spontaneous recovery in the cardiac function...

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Autores principales: Capponi, Guglielmo, Giovannini, Mattia, Koniari, Ioanna, Mori, Francesca, Rubino, Chiara, Spaziani, Gaia, Calabri, Giovanni Battista, Favilli, Silvia, Novembre, Elio, Indolfi, Giuseppe, De Simone, Luciano, Trapani, Sandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461009/
https://www.ncbi.nlm.nih.gov/pubmed/34568441
http://dx.doi.org/10.3389/fcvm.2021.676188
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author Capponi, Guglielmo
Giovannini, Mattia
Koniari, Ioanna
Mori, Francesca
Rubino, Chiara
Spaziani, Gaia
Calabri, Giovanni Battista
Favilli, Silvia
Novembre, Elio
Indolfi, Giuseppe
De Simone, Luciano
Trapani, Sandra
author_facet Capponi, Guglielmo
Giovannini, Mattia
Koniari, Ioanna
Mori, Francesca
Rubino, Chiara
Spaziani, Gaia
Calabri, Giovanni Battista
Favilli, Silvia
Novembre, Elio
Indolfi, Giuseppe
De Simone, Luciano
Trapani, Sandra
author_sort Capponi, Guglielmo
collection PubMed
description A 12-year-old male patient suffering from congenital glaucoma developed bradycardia, left ventricular failure, and hypotension after induction of anesthesia. Electrocardiography and echocardiography revealed a complete normalization of ECG and a complete spontaneous recovery in the cardiac function 72 hours from the beginning of the clinical manifestations, while cardiac Magnetic Resonance Imaging was performed, and coronary Computed Tomography scan revealed a myocardial bridge of a tract of the left anterior descendent coronary artery. Diagnosis of Kounis syndrome (KS) was made, a relatively novel, under-recognized clinical condition, defined as the manifestation of an acute coronary syndrome accompanied by mast cell activation and platelet aggregation involving interrelated and interacting inflammatory cells in the setting of allergic, hypersensitivity, anaphylactic or anaphylactoid insults. We described one of the first pediatric cases of KS related to anesthetic medications. In children, this syndrome has been only described in isolated case reports or small case series. Thus, it appears critical to report new cases of KS in children to increase the awareness of this disease in pediatric healthcare workers so as to enhance its early recognition and optimal therapeutic strategy. Furthermore, it appears of paramount importance the implementation of universal guidelines accepted by allergology and cardiology societies, in order to standardize the management of pediatric and adult patients with KS. Finally, a close collaboration between pediatric allergists and cardiologists seems fundamental for an optimal multidisciplinary patient care.
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spelling pubmed-84610092021-09-25 Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma Capponi, Guglielmo Giovannini, Mattia Koniari, Ioanna Mori, Francesca Rubino, Chiara Spaziani, Gaia Calabri, Giovanni Battista Favilli, Silvia Novembre, Elio Indolfi, Giuseppe De Simone, Luciano Trapani, Sandra Front Cardiovasc Med Cardiovascular Medicine A 12-year-old male patient suffering from congenital glaucoma developed bradycardia, left ventricular failure, and hypotension after induction of anesthesia. Electrocardiography and echocardiography revealed a complete normalization of ECG and a complete spontaneous recovery in the cardiac function 72 hours from the beginning of the clinical manifestations, while cardiac Magnetic Resonance Imaging was performed, and coronary Computed Tomography scan revealed a myocardial bridge of a tract of the left anterior descendent coronary artery. Diagnosis of Kounis syndrome (KS) was made, a relatively novel, under-recognized clinical condition, defined as the manifestation of an acute coronary syndrome accompanied by mast cell activation and platelet aggregation involving interrelated and interacting inflammatory cells in the setting of allergic, hypersensitivity, anaphylactic or anaphylactoid insults. We described one of the first pediatric cases of KS related to anesthetic medications. In children, this syndrome has been only described in isolated case reports or small case series. Thus, it appears critical to report new cases of KS in children to increase the awareness of this disease in pediatric healthcare workers so as to enhance its early recognition and optimal therapeutic strategy. Furthermore, it appears of paramount importance the implementation of universal guidelines accepted by allergology and cardiology societies, in order to standardize the management of pediatric and adult patients with KS. Finally, a close collaboration between pediatric allergists and cardiologists seems fundamental for an optimal multidisciplinary patient care. Frontiers Media S.A. 2021-09-10 /pmc/articles/PMC8461009/ /pubmed/34568441 http://dx.doi.org/10.3389/fcvm.2021.676188 Text en Copyright © 2021 Capponi, Giovannini, Koniari, Mori, Rubino, Spaziani, Calabri, Favilli, Novembre, Indolfi, De Simone and Trapani. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Capponi, Guglielmo
Giovannini, Mattia
Koniari, Ioanna
Mori, Francesca
Rubino, Chiara
Spaziani, Gaia
Calabri, Giovanni Battista
Favilli, Silvia
Novembre, Elio
Indolfi, Giuseppe
De Simone, Luciano
Trapani, Sandra
Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma
title Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma
title_full Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma
title_fullStr Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma
title_full_unstemmed Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma
title_short Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma
title_sort case report: perioperative kounis syndrome in an adolescent with congenital glaucoma
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461009/
https://www.ncbi.nlm.nih.gov/pubmed/34568441
http://dx.doi.org/10.3389/fcvm.2021.676188
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