Kounis syndrome and atrial fibrillation after bee sting: A case report

Abstract

A BSTRACT Bee sting can lead to allergic reactions which can present as life-threatening emergencies. Kounis syndrome is an acute coronary syndrome caused by mast cell activation after exposure to an allergen. Atrial fibrillation (AF) along with Kounis syndrome after allergen exposure is a rare presentation. A 40-year-old male patient presented to the emergency department (ED) with multiple bee stings to the face and neck. He complained of retrosternal chest pain along with facial pain and swelling. An electrocardiogram (ECG) showed AF with ST elevation in aVR and generalized ST segment depression. Troponin levels were elevated. He was diagnosed with Kounis syndrome along with AF secondary to a bee sting. The patient improved symptomatically with removal of stings and conservative management (steroids, antihistamines, antiplatelet drugs). ECG reverted to sinus rhythm and resolution of ST-T changes. He was discharged from the ED in stable condition. The bee sting may lead to significant cardiovascular events such as AF and Kounis syndrome, which require a high index of suspicion and prompt treatment. Kounis syndrome should be suspected in the ED in young patients with no cardiovascular risk factors after exposure to an allergen.

Kounis Syndrome: Myocardial Infarction After Wasp Bites

“…в своем обзоре 2022г. предлагают тактику лечения пациента с СК II типа [13]. В основе ведения пациента с СК II типа должен быть протокол лечения ОКС с совместным применением ГКС и антигистаминных препаратов.…”

Kounis Syndrome: Bee Sting-Induced Acute Myocardial Infarction

“…Kadeli et al reported a case of a severe allergic response to the angiography dye, which led to an inferior wall myocardial infarction [7]. Gopinath et al reported a case of bee sting-induced KS with atrial fibrillation [12]. Prasad et al reported a case of multiorgan dysfunction following multiple bee stings [4].…”

Principales componentes bioactivos y propiedades terapéuticas del veneno de abeja (Apis mellifera L.). Revisión

“…Otro tipo de complicaciones reportadas, no tan comunes, son: trombocitopenia inmunitaria (68) , linfedema (69) , síndrome de Guillain -Barré (70) , neuropatía óptica (71) , infarto pontino y talámico (72) , lesiones renales agudas (73) , síndrome de Wolff-Parkinson-White (74) , síndrome de Kounis (75) , pénfigo foliáceo (76) , por mencionar algunas. Estas complicaciones se deben principalmente a la acción inmunoestimuladora, y a la presencia de múltiples alérgenos proteicos con actividad enzimática e inductores de la IgE presentes en el VAM (18) .…”