Department of Cardiology, Peking University People's Hospital, Beijing, China.
Department of Radiology, Peking University People's Hospital, Beijing, China.
BMC Cardiovasc Disord. 2021 Mar 12;21(1):133. doi: 10.1186/s12872-021-01936-4.
Kounis syndrome is an acute coronary syndrome that appears in the setting of anaphylactic reaction or hypersensitivity. Many drugs and environmental exposures have been identified as potential offenders, and diagnosis and treatment can be challenging.
A 62-year-old man with recurrent bladder cancer underwent an intra-iliac artery epirubicin injection. After the injection, he developed chest pain and a systemic allergic reaction, with electrocardiographic alterations and elevated troponin-I levels. Emergent coronary angiography showed right coronary artery spasm and no stenosis of the other coronary arteries. This reaction was considered compatible with an allergic coronary vasospasm. A diagnosis of Kounis syndrome was made.
Kounis syndrome is common, but a prompt diagnosis is often not possible. This case is the first to suggest that an intraarterial epirubicin injection could potentially be one of its triggers. All physicians should be aware of the pathophysiology of this condition to better recognize it and start appropriate treatment; this will prevent aggravation of the vasospastic cardiac attacks and yield a better outcome.
Kounis 综合征是一种在过敏反应或超敏反应情况下出现的急性冠状动脉综合征。许多药物和环境暴露已被确定为潜在的罪魁祸首，其诊断和治疗具有挑战性。
一名 62 岁男性，患有复发性膀胱癌，接受了髂内动脉表阿霉素注射。注射后，他出现胸痛和全身性过敏反应，心电图改变和肌钙蛋白 I 水平升高。紧急冠状动脉造影显示右冠状动脉痉挛，其他冠状动脉无狭窄。这种反应被认为与过敏性冠状动脉血管痉挛相符。诊断为 Kounis 综合征。
Kounis 综合征很常见，但通常无法及时诊断。本例是首例提示动脉内表阿霉素注射可能是其触发因素之一的病例。所有医生都应了解这种疾病的病理生理学，以便更好地识别并开始适当的治疗；这将防止血管痉挛性心脏病发作的恶化并获得更好的结果。
