Iyonaga Takeshi, Ichiki Toshihiro, Watanabe Takanori, Masuda Seigo, Yamamoto Mitsutaka, Akatsuka Yutaka, Taira Yuji
Department of Cardiology, Harasanshin Hospital, Fukuoka, Japan.
J Cardiol Cases. 2015 Jun 12;12(4):106-109. doi: 10.1016/j.jccase.2015.05.007. eCollection 2015 Oct.
Kounis syndrome, which is known as allergic angina and allergic myocardial infarction today, was described as the coexistence of acute coronary syndrome with allergic reactions in 1991 by Kounis and Zavras. We report a case of a 79-year-old man with hypertension, hepatocellular carcinoma (HCC), and no allergic history. He had received transcatheter arterial chemoembolization (TACE) for treatment of HCC five times without allergic reactions. At the sixth time of TACE, he presented an anaphylactic reaction such as systemic erythema and severe arterial hypotension. Simultaneously, he complained of anterior chest pain and electrocardiogram showed significant ST segment elevation in inferior leads, indicating inferior myocardial infarction. Emergency coronary angiography, however, did not demonstrate any organic stenoses or occluded lesions of the coronary arteries. We made the diagnosis of Kounis syndrome associated with TACE. Although Kounis syndrome is a rare condition, physicians should be aware of possible co-occurrence of anaphylactic reactions and acute coronary syndrome. < Kounis syndrome refers to acute coronary syndrome associated with allergic or anaphylactic reactions. Physicians have to be aware and keep Kounis syndrome in mind whenever they encounter patients with an anaphylactic reaction. And immediate diagnosis and prompt treatment are needed.>.
库尼斯综合征，如今被称为过敏性心绞痛和过敏性心肌梗死，1991年由库尼斯和扎夫拉斯描述为急性冠状动脉综合征与过敏反应并存。我们报告一例79岁男性患者，患有高血压、肝细胞癌（HCC），且无过敏史。他因肝细胞癌接受了5次经导管动脉化疗栓塞术（TACE），均未出现过敏反应。在第6次TACE时，他出现了过敏反应，如全身红斑和严重动脉低血压。同时，他主诉前胸疼痛，心电图显示下壁导联ST段明显抬高，提示下壁心肌梗死。然而，急诊冠状动脉造影未显示冠状动脉有任何器质性狭窄或闭塞病变。我们诊断为与TACE相关的库尼斯综合征。尽管库尼斯综合征是一种罕见疾病，但医生应意识到过敏反应和急性冠状动脉综合征可能同时发生。<库尼斯综合征是指与过敏或过敏反应相关的急性冠状动脉综合征。医生在遇到过敏反应患者时必须意识到并牢记库尼斯综合征。需要立即诊断并及时治疗。>
