Ballesteros Ravi Vazirani, Polo Juan Carlos Gómez, Olmos Carmen, Vilacosta Isidre
Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain.
Case Rep Cardiol. 2023 Sep 14;2023:7706104. doi: 10.1155/2023/7706104. eCollection 2023.
. The term "ATAK" complex has been coined by the association of adrenaline, takotsubo, anaphylaxis and Kounis syndrome. We present an uncommon case of an "ATAK" complex with biphasic onset and a midventricular takotsubo pattern. . A 50-year-old male was brought to the emergency department in anaphylactic shock. He had progressive exertional dyspnea and angina for the past 2 days. The intravenous administration of adrenaline for anaphylactic shock resulted in chest pain and concerning ECG repolarization findings. The patient was immediately transferred to the catheterization laboratory. Coronary angiography showed a midventricular ballooning pattern without significant coronary stenosis, with subsequent recovery during hospitalization, suggestive of takotsubo syndrome. The allergy tests remained inconclusive for the trigger. . Adrenaline-mediated stress is the link between these two entities, in which Kounis syndrome itself or anaphylactic shock treatment (adrenaline) are potential triggers for takotsubo syndrome.
“ATAK”综合征这一术语是由肾上腺素、应激性心肌病、过敏反应和库尼斯综合征联合而成。我们报告一例罕见的具有双相发作和心室中部应激性心肌病模式的“ATAK”综合征病例。一名50岁男性因过敏性休克被送往急诊科。在过去两天里，他有进行性劳力性呼吸困难和心绞痛。因过敏性休克静脉注射肾上腺素后出现胸痛及令人担忧的心电图复极异常表现。患者立即被转至导管室。冠状动脉造影显示心室中部气球样改变，无明显冠状动脉狭窄，住院期间随后恢复，提示应激性心肌病综合征。过敏试验未能明确触发因素。肾上腺素介导的应激是这两种情况之间的联系，其中库尼斯综合征本身或过敏性休克治疗（肾上腺素）是应激性心肌病综合征的潜在触发因素。
