Frangides Christos, Kouni Sophia, Niarchos Costas, Koutsojannis Constantinos
Department of Internal Medicine, "Saint Andrews" State General Hospital, Patras, Greece.
Eur J Intern Med. 2006 May;17(3):215-6. doi: 10.1016/j.ejim.2005.11.016.
A 60-year-old male was bitten by a venomous snake (Vipera ammodytes) and gradually developed signs of an allergic reaction including generalized itching, generalized rash, and chest discomfort. This was followed by severe retrosternal pain with electrocardiographic evidence of an inferior myocardial ischemia progressing to acute myocardial infarction. Cardiac enzymes and troponin, serum tryptase, and histamine were elevated. Coronary arteriography showed normal coronary arteries. This is a characteristic type I variant of Kounis syndrome, which is the concurrence of acute coronary syndromes with conditions associated with mast cell activation including allergic or hypersensitivity reactions as well as anaphylactic or anaphylactoid reactions. This is the first report to show that viper bites can induce allergic angina and/or allergic myocardial infarction.
一名60岁男性被毒蛇（极北蝰）咬伤，逐渐出现过敏反应体征，包括全身瘙痒、全身性皮疹和胸部不适。随后出现严重的胸骨后疼痛，心电图显示下壁心肌缺血进展为急性心肌梗死。心肌酶、肌钙蛋白、血清类胰蛋白酶和组胺升高。冠状动脉造影显示冠状动脉正常。这是库尼斯综合征的一种典型I型变体，即急性冠状动脉综合征与包括过敏或超敏反应以及过敏或类过敏反应在内的肥大细胞活化相关疾病同时出现。这是首份表明蝰蛇咬伤可诱发过敏性心绞痛和/或过敏性心肌梗死的报告。
