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复发性冠状动脉痉挛:一例由造影剂过敏引发的 Kounis 综合征。

Recurrent Coronary Vasospasm: A Case of Kounis Syndrome from Anaphylaxis to Contrast Dye.

机构信息

Cook County Health, Chicago, Illinois, US.

Rush Medical College, Chicago, Illinois, US.

出版信息

Methodist Debakey Cardiovasc J. 2022 Jun 28;18(1):29-36. doi: 10.14797/mdcvj.1084. eCollection 2022.

Abstract

Kounis syndrome is characterized by acute coronary syndrome due to coronary vasospasm or thrombosis following exposure to an allergic stimulus. The presentation can be compounded by cardiovascular collapse due to cardiogenic shock from coronary vasospasm and associated vasodilatory shock from anaphylaxis. A high index of suspicion is crucial for prompt initiation of treatment, which focuses on managing the allergic or anaphylactic process. Here we present a case of coronary vasospasm and anaphylactic shock due to contrast dye exposure during percutaneous coronary intervention of an unstable coronary lesion and its associated diagnostic and therapeutic challenges.

摘要

Kounis 综合征的特征为在接触过敏刺激物后,出现由冠脉痉挛或血栓导致的急性冠脉综合征。由于冠脉痉挛导致心源性休克和过敏反应引起的血管扩张性休克,可能会使心血管崩溃的情况变得更加复杂。对迅速开始治疗保持高度怀疑是至关重要的,治疗的重点在于管理过敏或过敏反应过程。在此,我们介绍了 1 例因不稳定型冠脉病变行经皮冠状动脉介入术时造影剂暴露导致的冠脉痉挛和过敏性休克病例,以及其相关的诊断和治疗挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2042/9248981/cdbbf5701b1e/mdcvj-18-1-1084-g1.jpg

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