first Department of Cardiology, Hippokration Hospital, Athens medical School, Athens, Greece.
Emergency Department. Academic Hospital of Parma, Italy.
Acta Biomed. 2020 Mar 19;91(1):134-138. doi: 10.23750/abm.v91i1.8176.
Anaphylactic cardiovascular events constitute an underrated cause of medical emergencies in hospitalized patients. Coronary arteries and myocardium are targeted by anaphylactic mediators leading to acute coronary syndrome and imminent cardiovascular collapse. Early diagnosis and high clinical suspicion are required to secure prompt life-saving treatment in these cases. However, physicians of both Cardiology and Internal Medicine Departments are not familiar with this condition. Recently, we diagnosed and treated a case of anaphylactic cardiovascular collapse manifesting as acute myocardial infarction following salad consumption. Notably, Kounis anaphylaxis-associated acute coronary syndrome is a rare cause of ST segment elevation myocardial infarction with normal or diseased coronary arteries. We recommend that Kounis syndrome and its variants should be taken into consideration in the differential diagnosis of ischemic heart disease in patients with signs of allergic reaction and/or medical history of previous allergic reactions, who experience acute coronary syndrome after exposure to certain environmental stimuli.
过敏性心血管事件构成住院患者医疗急症中被低估的一个病因。过敏性介质会靶向冠状动脉和心肌，导致急性冠状动脉综合征和即将发生的心源性休克。在这些情况下，需要早期诊断和高度临床怀疑，以确保及时进行救生治疗。然而，心内科和内科医生都不熟悉这种情况。最近，我们诊断并治疗了一例食用沙拉后出现过敏性心血管衰竭表现为急性心肌梗死的病例。值得注意的是，Kounis 过敏相关性急性冠状动脉综合征是一种罕见的 ST 段抬高型心肌梗死病因，其冠状动脉正常或存在病变。我们建议，对于有过敏反应体征和/或既往过敏反应病史的患者，在出现急性冠状动脉综合征后暴露于某些环境刺激因素时，应考虑 Kounis 综合征及其变体作为缺血性心脏病的鉴别诊断。
