一例罕见的继发于碘化造影剂的2型库尼斯综合征。
A rare case of type 2 Kounis syndrome secondary to iodinated contrast.
作者信息
Nasrollahi Farrah Shahrzad, Friend Lauren, Patel Keshav, Behan Sean, Ibrahim Khalil
机构信息
University of Illinois at Chicago, Chicago, IL, USA.
出版信息
J Cardiol Cases. 2023 Oct 13;29(1):43-46. doi: 10.1016/j.jccase.2023.09.008. eCollection 2024 Jan.
UNLABELLED
Immune-mediated acute coronary syndrome, also known as Kounis syndrome (KS), is an underrecognized and challenging diagnosis. In this case report, we present a case of cardiac arrest secondary to iodinated contrast allergy requiring emergent cardiac catheterization and hemodynamic support secondary to type 2 KS. KS necessitates a high index of clinical suspicion by the treating physician in order to address both the hypersensitivity reaction and its cardiac implications.
LEARNING OBJECTIVES
Kounis syndrome (KS) is a clinically distinct entity from anaphylaxis; managing KS in the same way as anaphylaxis can worsen cardiac demand and ischemia. In addition, KS may present as coronary vasospasm or plaque rupture; regardless, percutaneous coronary intervention (PCI) should be performed as worse outcomes have been described in cases where PCI is not performed or delayed.
未标注
免疫介导的急性冠状动脉综合征，也称为库尼斯综合征（KS），是一种未被充分认识且具有挑战性的诊断。在本病例报告中，我们呈现了一例因碘造影剂过敏继发心脏骤停的病例，该病例需要紧急心脏导管插入术以及因2型KS继发的血流动力学支持。KS需要主治医生保持高度的临床怀疑指数，以便同时应对过敏反应及其心脏方面的影响。
学习目标
库尼斯综合征（KS）在临床上与过敏反应是不同的实体；以与过敏反应相同的方式处理KS会加重心脏负担和缺血。此外，KS可能表现为冠状动脉痉挛或斑块破裂；无论如何，均应进行经皮冠状动脉介入治疗（PCI），因为在未进行PCI或延迟进行PCI的病例中已描述了更差的预后。
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