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Allergy Associated Myocardial Infarction: A Comprehensive Report of Clinical Presentation, Diagnosis and Management of Kounis Syndrome

Kounis syndrome (KS) has been defined as acute coronary syndrome (ACS) in the context of a hypersensitivity reaction. Patients may present with normal coronary arteries (Type I), established coronary artery disease (Type II) or in-stent thrombosis and restenosis (Type III). We searched PubMed until...

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Autores principales: Roumeliotis, Anastasios, Davlouros, Periklis, Anastasopoulou, Maria, Tsigkas, Grigorios, Koniari, Ioanna, Mplani, Virginia, Hahalis, Georgios, Kounis, Nicholas G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781167/
https://www.ncbi.nlm.nih.gov/pubmed/35062699
http://dx.doi.org/10.3390/vaccines10010038
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author Roumeliotis, Anastasios
Davlouros, Periklis
Anastasopoulou, Maria
Tsigkas, Grigorios
Koniari, Ioanna
Mplani, Virginia
Hahalis, Georgios
Kounis, Nicholas G.
author_facet Roumeliotis, Anastasios
Davlouros, Periklis
Anastasopoulou, Maria
Tsigkas, Grigorios
Koniari, Ioanna
Mplani, Virginia
Hahalis, Georgios
Kounis, Nicholas G.
author_sort Roumeliotis, Anastasios
collection PubMed
description Kounis syndrome (KS) has been defined as acute coronary syndrome (ACS) in the context of a hypersensitivity reaction. Patients may present with normal coronary arteries (Type I), established coronary artery disease (Type II) or in-stent thrombosis and restenosis (Type III). We searched PubMed until 1 January 2020 for KS case reports. Patients with age <18 years, non-coronary vascular manifestations or without an established diagnosis were excluded. Information regarding patient demographics, medical history, presentation, allergic reaction trigger, angiography, laboratory values and management were extracted from every report. The data were pulled in a combined dataset. From 288 patients with KS, 57.6% had Type I, 24.7% Type II and 6.6% Type III, while 11.1% could not be classified. The mean age was 54.1 years and 70.6% were male. Most presented with a combination of cardiac and allergic symptoms, with medication being the most common trigger. Electrocardiographically, 75.1% had ST segment elevation with only 3.3% demonstrating no abnormalities. Coronary imaging was available in 84.8% of the patients, showing occlusive lesions (32.5%), vascular spasm (16.2%) or normal coronary arteries (51.3%). Revascularization was pursued in 29.4% of the cases. In conclusion, allergic reactions may be complicated by ACS. KS should be considered in the differential diagnosis of myocardial infarction with non-obstructive coronary arteries.
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spelling pubmed-87811672022-01-22 Allergy Associated Myocardial Infarction: A Comprehensive Report of Clinical Presentation, Diagnosis and Management of Kounis Syndrome Roumeliotis, Anastasios Davlouros, Periklis Anastasopoulou, Maria Tsigkas, Grigorios Koniari, Ioanna Mplani, Virginia Hahalis, Georgios Kounis, Nicholas G. Vaccines (Basel) Article Kounis syndrome (KS) has been defined as acute coronary syndrome (ACS) in the context of a hypersensitivity reaction. Patients may present with normal coronary arteries (Type I), established coronary artery disease (Type II) or in-stent thrombosis and restenosis (Type III). We searched PubMed until 1 January 2020 for KS case reports. Patients with age <18 years, non-coronary vascular manifestations or without an established diagnosis were excluded. Information regarding patient demographics, medical history, presentation, allergic reaction trigger, angiography, laboratory values and management were extracted from every report. The data were pulled in a combined dataset. From 288 patients with KS, 57.6% had Type I, 24.7% Type II and 6.6% Type III, while 11.1% could not be classified. The mean age was 54.1 years and 70.6% were male. Most presented with a combination of cardiac and allergic symptoms, with medication being the most common trigger. Electrocardiographically, 75.1% had ST segment elevation with only 3.3% demonstrating no abnormalities. Coronary imaging was available in 84.8% of the patients, showing occlusive lesions (32.5%), vascular spasm (16.2%) or normal coronary arteries (51.3%). Revascularization was pursued in 29.4% of the cases. In conclusion, allergic reactions may be complicated by ACS. KS should be considered in the differential diagnosis of myocardial infarction with non-obstructive coronary arteries. MDPI 2021-12-29 /pmc/articles/PMC8781167/ /pubmed/35062699 http://dx.doi.org/10.3390/vaccines10010038 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Roumeliotis, Anastasios
Davlouros, Periklis
Anastasopoulou, Maria
Tsigkas, Grigorios
Koniari, Ioanna
Mplani, Virginia
Hahalis, Georgios
Kounis, Nicholas G.
Allergy Associated Myocardial Infarction: A Comprehensive Report of Clinical Presentation, Diagnosis and Management of Kounis Syndrome
title Allergy Associated Myocardial Infarction: A Comprehensive Report of Clinical Presentation, Diagnosis and Management of Kounis Syndrome
title_full Allergy Associated Myocardial Infarction: A Comprehensive Report of Clinical Presentation, Diagnosis and Management of Kounis Syndrome
title_fullStr Allergy Associated Myocardial Infarction: A Comprehensive Report of Clinical Presentation, Diagnosis and Management of Kounis Syndrome
title_full_unstemmed Allergy Associated Myocardial Infarction: A Comprehensive Report of Clinical Presentation, Diagnosis and Management of Kounis Syndrome
title_short Allergy Associated Myocardial Infarction: A Comprehensive Report of Clinical Presentation, Diagnosis and Management of Kounis Syndrome
title_sort allergy associated myocardial infarction: a comprehensive report of clinical presentation, diagnosis and management of kounis syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781167/
https://www.ncbi.nlm.nih.gov/pubmed/35062699
http://dx.doi.org/10.3390/vaccines10010038
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