Takotsubo cardiomyopathy associated with Kounis syndrome: A clinical case of the “ATAK complex”

Abstract

Takotsubo cardiomyopathy (TT) is a disease characterized by clinical, biomarker, electrocardiographic (ECG), and echocardiographic patterns that suggest an acute coronary syndrome [1]. TT usually affects elderly women, and is preceded by an emotional or physical trigger. Left ventricular (LV) systolic and diastolic dysfunction are transient and extend beyond the vascular territory subtended by a single coronary artery. The pathogenesis of this disease remains unknown, but many research data support the possible role of the brain-heart axis, endothelial dysfunction, epicardial, and microvascular damage [2]. Kounis syndrome (KS) is defined as an acute coronary syndrome which arises after an allergic or anaphylactic trigger. This syndrome mainly affects males between the age of 40 and 70 years, and includes as risk factors history of previous allergy, smoking, hyperlipidemia, and systemic arterial hypertension. Various agents have been found to trigger KS, the most common being antibiotics and insect bites [3].We report an unusual clinical case with several elements common to both TT and KS. This case underlines how these disorders may overlap in the pathophysiology and in the clinical presentation and how they may converge in the scenario of

Kounis Syndrome Associated With Takotsubo Syndrome in an Adolescent With Peutz-Jeghers Syndrome

“…According to the clinical data collected, our patient had KS associated with TTS. Indeed, as already demonstrated in published reports, both TTS and KS can coexist in the same patient ( 10 ). However, the adolescent in our case had a favorable outcome.…”

Acute Coronary Syndrome After Ondansetron Administration in a Pregnant Woman

“…Patients with KS can present with acute angina without an increase in cardiac markers or myocardial infarction. Cases of anaphylactic or cardiogenic shock as the primary manifestation of this condition have also been reported ( 6 , 7 ).…”

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

“…Sometimes, it can be difficult to distinguish takotsubo syndrome from KS and, as already reported, in some cases they can even coexist (23,24). Interestingly, both these conditions share some common pathologic mechanisms: vascular hyperreactivity of coronary arteries and local/systemic cellular or humoral inflammatory response in inducing myocardial damage (25,26).…”