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库尼斯综合征:一例由万古霉素相关冠状动脉痉挛导致心肌梗死的病例。

Kounis Syndrome: A Case of Vancomycin-Associated Coronary Artery Vasospasm Resulting in Myocardial Infarction.

作者信息

Gagnon Luke R, Huang Yiming, Kay Robert, Cujec Bibiana

机构信息

Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.

出版信息

CJC Open. 2021 Nov 17;4(3):337-339. doi: 10.1016/j.cjco.2021.11.003. eCollection 2022 Mar.

Abstract

We describe a case of Kounis syndrome, an allergic reaction causing coronary artery vasospasm, triggered by a vancomycin infusion, in a healthy 32-year-old man. The patient initially presented with an inguinal abscess requiring intravenous vancomycin. During his third infusion, he developed typical chest pain that resolved with cessation of the infusion. Troponin was elevated, and electrocardiogram showed ST elevation, prompting emergent cardiac catheterization that demonstrated normal coronary arteries. The cause of the myocardial infarction was consistent with Kounis syndrome. Diagnosis of Kounis syndrome is important, as prompt cessation of the offending agent is a priority to reduce further cardiac injury.

摘要

我们描述了一例库尼斯综合征病例,这是一种由万古霉素输注引发的、导致冠状动脉血管痉挛的过敏反应,患者为一名32岁的健康男性。该患者最初因腹股沟脓肿就诊,需要静脉输注万古霉素。在第三次输注过程中,他出现了典型的胸痛,停止输注后胸痛缓解。肌钙蛋白升高,心电图显示ST段抬高,促使其紧急进行心脏导管检查,结果显示冠状动脉正常。心肌梗死的病因符合库尼斯综合征。库尼斯综合征的诊断很重要,因为迅速停用致病药物是减轻进一步心脏损伤的首要任务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4055/8978073/b5f97a8cc468/gr1.jpg

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