Kakumoto Takuya, Kawamata Hirofumi, Hori Masatoshi, Harimoto Kuniyasu, Kawasaki Tatsuya
Department of Cardiology, Matsushita Memorial Hospital, Moriguchi, JPN.
Department of Emergency Medicine, Matsushita Memorial Hospital, Moriguchi, JPN.
Cureus. 2025 Apr 29;17(4):e83208. doi: 10.7759/cureus.83208. eCollection 2025 Apr.
Kounis syndrome is an acute coronary syndrome triggered by allergic hypersensitivity to various stimuli. Here, we report the case of a 54-year-old man who had coronary stent-induced type III Kounis syndrome. The patient developed a rash on the anterior chest wall and experienced throat discomfort 40 minutes after stent implantation in the left anterior descending artery. Given his history of allergies, a presumptive diagnosis of anaphylaxis was made, and 0.5 mg of adrenaline was injected intramuscularly into the left thigh. The patient's symptoms initially resolved; however, approximately 50 minutes after the onset of the allergic reaction, he developed chest pain accompanied by ST-segment elevation in the anterior leads. Emergency coronary angiography revealed total occlusion at the mid-portion of the distal stent implanted in the left anterior descending artery, which was treated with repeated ballooning. The patient was later found to have a metal allergy. This case highlights the importance of obtaining a thorough allergy history, particularly regarding metal allergies, and recognizing Kounis syndrome as a potential cause of stent thrombosis associated with allergic hypersensitivity during coronary interventions.
库尼斯综合征是一种由对各种刺激的过敏性超敏反应引发的急性冠状动脉综合征。在此，我们报告一例54岁男性发生冠状动脉支架诱导的III型库尼斯综合征的病例。患者在左前降支植入支架40分钟后，前胸壁出现皮疹并伴有咽喉不适。鉴于其过敏史，初步诊断为过敏反应，并在左大腿肌肉注射了0.5毫克肾上腺素。患者症状最初有所缓解；然而，在过敏反应发作约50分钟后，他出现胸痛并伴有前壁导联ST段抬高。急诊冠状动脉造影显示，植入左前降支的远端支架中段完全闭塞，经反复球囊扩张治疗。该患者后来被发现对金属过敏。本病例强调了全面了解过敏史的重要性，尤其是关于金属过敏，并认识到库尼斯综合征是冠状动脉介入治疗期间与过敏性超敏反应相关的支架血栓形成的潜在原因。
