scholarly journals Anaphylaxis from Wasp Stings Inducing Coronary Thrombus

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Sazzli Kasim ◽  
Rafidah AbuBakar ◽  
Eugene McFadden
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Acute Coronary Syndromes ◽  
Mast Cell Degranulation ◽  
Kounis Syndrome ◽  
Coronary Syndrome ◽  
Rare Manifestation ◽  
Coronary Syndromes ◽  
Wasp Stings ◽  
Allergic Angina

Myocardial infarction as a result of wasp stings is a rare manifestation of acute coronary syndromes. It has been ascribed to kounis syndrome or allergic angina whose triggers include mast cell degranulation leading to coronary vasospasm and/or local plaque destabilisation. Its exact pathophysiology is still not clearly defined. We present a case of an acute coronary syndrome as a consequence of wasp stings and discuss its possible aetiology.

scholarly journals Kounis syndrome after almonds ingestion: From the diagnostic approach to new therapeutic options

2021 ◽  
Vol 17 (3) ◽  
Author(s):  
Giorgio Fiore ◽  
Carlo Gaspardone ◽  
Silvana Di Maio ◽  
Michele Oppizzi ◽  
Alberto Margonato
Keyword(s):  
Acute Coronary Syndrome ◽  
Emergency Physician ◽  
Acute Coronary Syndromes ◽  
Correct Diagnosis ◽  
Kounis Syndrome ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
Anaphylactoid Reactions ◽  
Patient Prognosis ◽  
Diagnostic Work

Acute coronary syndromes can develop with an unusual and challenging presentation. Kounis syndrome is a mostly overlooked Acute Coronary Syndrome (ACS) in the setting of anaphylactic or anaphylactoid reactions in response to an allergic insult that can lead to severe complications including cardiac arrest. A 52-yearold- man presented to the emergency department of our hospital because of acute transient loss of consciousness that developed some minutes after almonds ingestion. The complex diagnostic workup led to the diagnosis of vasospastic Kounis syndrome, an infrequent type of acute coronary syndrome, mostly overlooked, with challenging diagnostic and therapeutic features. Peculiarities on clinical presentation, the approach adopted by the emergency physician and the consultant cardiologist to achieve the correct diagnosis and our proposed management with a brief revision of the literature will be reported. Unusual clinical presentations of acute coronary syndromes represent part of the pitfalls that an emergency physician can face during the everyday practice. Prompt identification of these conditions is always struggling but of crucial importance to improve patient prognosis with a correct diagnostic work-up and therapeutic management.

scholarly journals Allergic acute coronary syndrome: Amoxicillin/clavulanic acid intake

2021 ◽  
Vol 11 (2) ◽  
pp. 064-068
Author(s):  
Filipa Ribeiro Lucas ◽  
João Gigante ◽  
Steve Harakeh ◽  
Pedro Vieira
Keyword(s):  
Acute Coronary Syndrome ◽  
Acute Coronary Syndromes ◽  
Myocardial Injury ◽  
Kounis Syndrome ◽  
Laboratory Findings ◽  
Coronary Syndrome ◽  
Antibiotic Allergy ◽  
Allergen Concentration ◽  
Amoxicillin Clavulanic Acid ◽  
Coronary Syndromes

Anaphylaxis rarely manifests as a vasospastic acute coronary syndrome (ACS). Kounis Syndrome (KS) is described as the coincidental occurrence of chest pain and clinical and laboratory findings of ACS. The prognosis depends on the magnitude of the initial allergic response, the patient’s sensitivity, comorbidities, the site of antibody antigen reaction, the allergen concentration, and the route of allergen entrance. We report a rare case of KS secondary to antibiotic allergy. This case may suggest that Kounis syndrome should be taught in the differential diagnosis of acute coronary syndromes. Clinicians should be aware of this adverse effect and consider it during diagnostic workup of myocardial injury.

scholarly journals Antiplatelet Therapy in Acute Coronary Syndrome

2017 ◽  
Vol 12 (1) ◽  
pp. 33 ◽  
Author(s):  
Kerry Layne ◽  
Albert Ferro ◽  
◽  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Unstable Angina ◽  
Acute Coronary Syndromes ◽  
Clinical Evidence ◽  
Drug Class ◽  
Antiplatelet Agents ◽  
Pharmacological Properties ◽  
Coronary Syndrome ◽  
Coronary Syndromes

Antiplatelet agents have for decades been used to improve outcomes in patients with acute coronary syndromes and have become increasingly valued, not only for their antithrombotic properties but also for their anti-inflammatory effects. The drug class continues to evolve as novel agents with increasingly efficacious antiplatelet actions are identified. This review will discuss antiplatelet agents, including aspirin, the P2Y12 receptor antagonists and the glycoprotein IIb/IIIa inhibitors, that are currently used to treat patients with unstable angina and myocardial infarction, focusing on their pharmacological properties and the clinical evidence supporting their use.

Anti-Platelet and Anti-Thrombotic Therapy Post-AMI

2011 ◽  
Author(s):  
Dana Dawson ◽  
Keith Fox
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Myocardial Reperfusion ◽  
St Elevation Myocardial Infarction ◽  
Coagulation Cascade ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation

• Acute coronary syndromes (ACS) encompass a spectrum of presentations which include unstable angina, non-ST-elevation myocardial infarction (NSTEMI or NSTE-ACS), and ST-elevation myocardial infarction (STEMI or STE-ACS)• Anti-platelet and anti-thrombotic agents are administered as ancillary therapy to myocardial reperfusion in patients presenting with an acute coronary syndrome, to maintain the patency of the infarct-related coronary artery• More specific and potent inhibitors of platelet activation and of the coagulation cascade are emerging with the aim being to further improve clinical outcomes in patients presenting with an acute coronary syndrome, without increasing the risks of major bleeding.

scholarly journals Possible Correlations between Atherosclerosis, Acute Coronary Syndromes and COVID-19

2020 ◽  
Vol 9 (11) ◽  
pp. 3746 ◽  
Author(s):  
Oliwia Grzegorowska ◽  
Jacek Lorkowski
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Inflammatory Response ◽  
Cardiovascular System ◽  
Acute Coronary Syndromes ◽  
Therapeutic Options ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
Global Concern ◽  
Excessive Inflammatory Response

An outbreak of SARS-CoV-2 infection in December 2019 became a major global concern in 2020. Since then, several articles analyzing the course, complications and mechanisms of the infection have appeared. However, there are very few papers explaining the possible correlations between COVID-19, atherosclerosis and acute coronary syndromes. We performed an analysis of PubMed, Cochrane, Google Scholar, and MEDLINE databases. As of September 15, 2020, the results were as follows: for “COVID-19” and “cardiovascular system” we obtained 687 results; for “COVID-19” and “myocardial infarction” together with “COVID-19” and “acute coronary syndrome” we obtained 328 results; for “COVID-19” and “atherosclerosis” we obtained 57 results. Some of them did not fulfill the search criteria or concerned the field of neurology. Only articles written in English, German and Polish were analyzed for a total number of 432 papers. While the link between inflammatory response, COVID- 19 and atherosclerosis still remains unclear, there is evidence that suggests a more likely correlation between them. Practitioners’ efforts should be focused on the prevention of excessive inflammatory response and possible complications, while there are limited specific therapeutic options against SARS-CoV-2. Furthermore, special attention should be paid to cardioprotection during the pandemic.

scholarly journals Anaemia in acute coronary syndrome patients: a study from rural tertiary care centre of India

2018 ◽  
Vol 6 (8) ◽  
pp. 2677
Author(s):  
Vivek Kumar Verma ◽  
Durga Prasad Singh ◽  
Dheeraj Kela ◽  
V. Vijayavarman ◽  
Geeta Singh
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Blood Loss ◽  
Unstable Angina ◽  
Acute Coronary Syndromes ◽  
Vitamin B12 Deficiency ◽  
Coronary Syndrome ◽  
B12 Deficiency ◽  
Coronary Syndromes ◽  
St Elevation

Background: Acute coronary syndromes (ACS) are an imbalance between myocardial oxygen supply and demand, and the presence of anaemia further potentiates this imbalance. The burden of anaemia in patients presenting with acute coronary syndromes (ACS) is significant. Anaemia has the potential to worsen myocardial ischemic insult by decreasing the oxygen content of the blood supplied to the jeopardized myocardium.Methods: A total of 148 patients with ACS were recruited in the study from October 2016 to December 2017 in Medicine and Cardiology Department of UPUMS Saifai, India. All patients were subjected to a detailed history and thorough clinical examination and investigations after obtaining informed consent. Patient having any other diseases known to cause anaemia were excluded.Results: Mean age of patients was 58.5 years. 72.97% were vegetarian and 27.03% were non-vegetarian. Most common morphological type of anaemia was dimorphic anaemia followed by macrocytic and microcytic hypochromic respectively. Iron deficiency anaemia was most common type of anaemia followed by vitamin B12 deficiency and mixed (Iron and vitamin B12 deficiency). 45.28% anaemic patients had no symptoms of blood loss. Most common symptom of blood loss was bleeding per rectum followed by malena. Severity of acute coronary syndrome was more in subjects having anaemia which was evident by higher incidence of anaemia in subjects having ST elevation myocardial infarction (STEMI). The incidence of anaemia was low in case of Non ST elevation Myocardial Infarction (NSTEMI) and Unstable angina (UA). The results of the present study have been compared to those from India.Conclusions: Higher incidence of anaemia was reported in subjects having acute coronary syndrome. Incidence of anaemia in STEMI patients was greater than NSTEMI and unstable angina patients. Severe form of acute coronary syndrome i.e. STEMI was associated with higher incidence of anaemia. 

scholarly journals Kounis Syndrome: Dexketoprofen-Associated ST-Elevation Myocardial Infarction

2021 ◽  
Author(s):  
Aytekin Aksakal ◽  
Zeki Simşek ◽  
Diyar Köprülü ◽  
Uğur Arslan
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndromes ◽  
Cell Activation ◽  
Wide Spectrum ◽  
Sudden Cardiac Arrest ◽  
Mast Cell Activation ◽  
Kounis Syndrome ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Allergic Angina

Allergic angina and allergic myocardial infarction are common diseases associated with acute coronary syndromes and encompass a wide spectrum of mast cell activation disorders termed "Kounis Syndrome". We present here a patient with Kounis syndrome presenting with sudden cardiac arrest after intravenous infusion of dexketoprofen in the emergency room.

scholarly journals Zespół Kounisa – interdyscyplinarny problem na styku alergologii i kardiologii y

Alergoprofil ◽  
2021 ◽  
Author(s):  
Magdalena Feusette ◽  
Katarzyna Kapeluszna ◽  
Łukasz Moos ◽  
Piotr Feusette ◽  
Jerzy Sacha ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Allergic Reaction ◽  
Kounis Syndrome ◽  
Coronary Syndrome ◽  
Disease States ◽  
Life Threatening ◽  
History Of ◽  
Systemic Hypersensitivity ◽  
Coronary Syndromes

Life-threatening anaphylaxis is a systemic hypersensitivity reaction that may be allergic or non-allergic. Kounis syndrome is an acute coronary syndrome caused by an allergic reaction. Food, environmental factors, drugs, radiological contrast agents and some disease states are among the etiological factors that trigger an allergic reaction. Kounis syndrome is a relatively rarely recognized cause of myocardial infarction, which is most likely due to its underdiagnosis. The presented case concerns a patient with a history of ischemic heart disease after coronary angioplasty. Until the insect stings, the course of the angina was stable. The course of the allergic reaction was turbulent and met the criteria for anaphylactic shock. Subsequently, the patient developed unstable angina. The clinical picture and additional tests allowed to diagnose a myocardial infarction in the patient. The coincidence of myocardial infarction with a history of an insect sting allows for the recognition of an allergic reaction as a trigger for acute coronary syndrome. The described case highlights the need for a multidisciplinary approach to the patient and regular supervision during the use of specific immunotherapy in the course of allergy to Hymenoptera venom, as well as the inclusion of Kounis syndrome in the differential diagnosis of acute coronary syndromes.

scholarly journals The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS): Design and Methodology

2021 ◽  
Vol 11 (2) ◽  
pp. 84-97
Author(s):  
Malcolm. E. Legget ◽  
Vicky. A. Cameron ◽  
Katrina. K. Poppe ◽  
Sara Aish ◽  
Nikki Earle ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
New Zealand ◽  
Acute Coronary Syndromes ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Prospective Longitudinal ◽  
First Time

Background. Each year, approximately 5000 New Zealanders are admitted to hospital with first-time acute coronary syndrome (ACS). The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) is a prospective longitudinal cohort study embedded within the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry in six hospitals. The objective of MENZACS is to examine the relationship between clinical, genomic, and cardiometabolic markers in relation to presentation and outcomes post-ACS. Methods. Patients with first-time ACS are enrolled and study-specific research data is collected alongside the ANZACS-QI registry. The research blood samples are stored for future genetic/biomarker assays. Dietary information is collected with a food frequency questionnaire and information about physical activity, smoking, and stress is also collected via questionnaire. Detailed family history, ancestry, and ethnicity data are recorded on all participants. Results. During the period between 2015 and 2019, there were 2015 patients enrolled. The mean age was 61 years, with 60% of patients aged <65 years and 21% were female. Ethnicity and cardiovascular (CV) risk factor distribution was similar to ANZACS-QI: 13% Māori, 5% Pacific, 5% Indian, and 74% NZ European. In terms of CV risk factors, 56% were ex-/current smokers, 42% had hypertension, and 19% had diabetes. ACS subtype was ST elevation myocardial infarction (STEMI) in 41%, non-ST elevation myocardial infarction (NSTEM) in 54%, and unstable angina in 5%. Ninety-nine percent of MENZACS participants underwent coronary angiography and 90% had revascularization; there were high rates of prescription of secondary prevention medications upon discharge from hospital. Conclusion. MENZACS represents a cohort with optimal contemporary management and will be a significant epidemiological bioresource for the study of environmental and genetic factors contributing to ACS in New Zealand’s multi-ethnic environment. The study will utilise clinical, nutritional, lifestyle, genomic, and biomarker analyses to explore factors influencing the progression of coronary disease and develop risk prediction models for health outcomes.

scholarly journals KOUNIS SYNDROME - ALLERGIC MYOCARDIAL INFARCTION. A CASE REPORT

2019 ◽  
Vol 72 (1) ◽  
pp. 137-141
Author(s):  
Olga Wajtryt ◽  
Tadeusz M Zielonka ◽  
Aleksandra Kaszyńska ◽  
Andrzej Falkowski ◽  
Katarzyna Życińska
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Allergic Reaction ◽  
Anaphylactic Shock ◽  
Coronary Artery Spasm ◽  
Kounis Syndrome ◽  
Permanent Damage ◽  
Coronary Syndrome

Kounis syndrome or allergic myocardial infarction is an acute coronary syndrome in the course of an allergic reaction. In allergic patients in response to a specific condition - nourishment, inhalation, environmental substances, drug or insect bite there is an allergic reaction involving many different cells and mediators that can cause coronary artery spasm or initiate the process of rupture and activation of atherosclerotic plaque resulting in acute coronary syndrome. The paper describes a case of a young man with allergy to pollen and confirmed sensitization to nuts, who developed a full-blown anaphylactic shock after eating the nut mix and experienced a rapidly passing acute coronary syndrome with troponin up to 4.7 μg/L. An increased concentration of tryptase (15 μg/L), total IgE (> 3,000 IU/mL) and specific anti-nut IgE (55.1 kUA/L) were found. Based on the course of the disease and the results of allergic and cardiac tests, allergic type 1 myocardial infarction, i.e. caused by coronary artery spasm, was diagnosed. During the hospitalization, the patient’s condition improved quickly and after a few days he left the hospital without the signs of permanent damage to the heart muscle.

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