J Invasive Cardiol. 2021 Nov;33(11):E920-E921.

Kounis Syndrome: Kill Two Birds With One Stone.

The Journal of invasive cardiology

Takehiro Yamashita, Yasunori Oguma, Nicholas G Kounis

PMID: 34735359

Abstract

A 59-year-old man with a 95% stenosis in his diagonal branch and no stenosis in the right coronary artery (RCA) or left circumflex artery was scheduled for PCI. After exhibiting symptoms consistent with type I Kounis syndrome (KS), nitroglycerin was administered. While giving him intravenous epinephrine to maintain his hemodynamics, the ST level recovered, and he became fully conscious. When he complained of chest pain, a new ST elevation was noticed in the lateral leads, with ST levels in the inferior leads turning into depression. Repeat angiography demonstrated neither spasm nor occlusion in the RCA, while the diagonal branch was completely occluded at the proximal portion, which was considered to be responsible for ST elevation in the lateral leads. This is the first reported case that combined 2 variants of KS in a single event.

Keywords: Kounis syndrome; ST change; allergy; cefazolin; two variants

MeSH terms

• Coronary Angiography
• Coronary Vessels / diagnostic imaging
• Electrocardiography
• Humans
• Kounis Syndrome* / diagnosis
• Kounis Syndrome* / etiology
• Male
• Middle Aged
• Percutaneous Coronary Intervention*

Publication Types

• Case Reports
• Journal Article