Kounis syndrome not induced but prevented by the implantation of a drug-eluting stent: a case report

Abstract

Figure 1. ECG image obtained after the first drug reaction. A 1-mm ST-segment depression in DI, DII, aVL, and aVF and T-wave negativity in V1-V4 were observed

A Case of Kounis Syndrome Presenting as Coronary Artery Spasm Associated with Acetaminophen Infusion

“…There were a few acetaminophen hypersensitivity cases reported in the literature, including a case series [ 12 ] that reported 13 cases from 01/1999 to 12/2012, with clinical presentations ranging from urticaria, angioedema, to type 2 anaphylaxis and wheezing. Despite this, only 1 case of paracetamol/propyphenazone-related Kounis syndrome has been reported [ 16 ], which was a male patient with type 2 Kounis syndrome who was treated with a paclitaxel-eluting stent placed in the culprit artery. Our patient is the second paracetamol-related Kounis syndrome to be documented, as well as the first case of type 1 paracetamol-related Kounis syndrome.…”

“…Patients with type 1 Kounis syndrome may benefit from allergy treatment because it also heals cardiac damage. Corticosteroids and antihistamine medications can also be used to reduce inflammation and alleviate allergic reactions [ 16 , 18 ]. Epinephrine should be used with caution in Kounis syndrome because it can aggravate ischemia, prolong the QT interval, and cause coronary spasms or arrhythmias [ 19 ].…”

Preventing Kounis syndrome by stent implantation: a reciprocal process?

“…In the very interesting report published in this journal by Terzioğlu et al ( 1 ) entitled “Kounis syndrome not induced but prevented by the implantation of a drug eluting stent: a case report.”, a 65-year-old male patient with hypertension and diabetes who underwent bypass graft surgery developed an acute allergic reaction with dyspnea, itching, hand swelling, retrosternal chest pain, and syncope following paracetamol/propyphenazone tablet administration. Type II Kounis syndrome was diagnosed, which manifested as non-STEMI.…”