In:
Military Medical and Pharmaceutical Journal of Serbia, National Library of Serbia, , No. 00 ( 2023), p. 37-37
Abstract:
Introduction. Kounis syndrome is a simultaneous manifestation of acute
coronary syndrome with conditions associated with mast cell activation, such
as allergies or anaphylactic reactions. We present early stent thrombosis in
female with atopic constitution without previous aterosclerosis of coronary
arteries. Case report. A 50-year-old female with typical anginal pain was
addmited to Clinic for Cardiology, UCC Nis. She had passed by a linden tree
in bloom, few hrs before, and immediately after felt chest pain, paresthesia
and numbnes in her left hand, throat tightness, heaviness of the tongue, and
swelling of the lips. Symptoms stopped for 60 min after taking 10 mg of
loratadine. 30 min after addmision ECG showed ST elevation in D2, D3, aVF,
V6. She underwent an emergency percutaneous coronary intervention (PCI)
procedure. Occlusive thrombosis was seen in the ostium of the left anterior
descending (LAD) coronary artery. Sirolimus-coated stent was placed with
Thrombolysis in Myocardial Infarction (TIMI) 3 flow obtained. A few hrs
later, patient reported a new onset of chest pain followed by ventrucular
fibrilation (VF), DC shock and occurence of new ST segment elevation in aVR,
V1-V3. Repeated angiography showed acute in-stent trombotic occlusion.
Baloon angioplasty was performed which restored TIMI 3 flow in LAD.
Anticoagulant and corticosteroid therapy was administered. Three days
following an intervention, optical coherence tomography (OCT) imiging showed
no signs of aterosclerosis and restenosis, adequate stent expansion and
apposition. Conclusion. Coronary agiography proved type I Kounis syndrome
after the exposure to an allergen, and type III Kounis syndrome developed
shortly after stent placement. Newly described causes of acute and subacute
stent thrombosis in type III Kounis syndrome are stent-associated
hypersensitivity reactions.
Type of Medium:
Online Resource
ISSN:
0042-8450
,
2406-0720
DOI:
10.2298/VSP230424037K
Language:
English
Publisher:
National Library of Serbia
Publication Date:
2023
detail.hit.zdb_id:
2169819-3
SSG:
15,3
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