Acute myocardial infarction due to Kounis syndrome: A case report

doi:10.12998/wjcc.v10.i31.11555

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Nov 6, 2022; 10(31): 11555-11560
Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11555

Acute myocardial infarction due to Kounis syndrome: A case report

Guang-Zhi Xu, Gang Wang

Guang-Zhi Xu, Gang Wang, Heart Centre, The Third Central Hospital of Tianjin, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China

Author contributions: Xu GZ and Wang G contributed to manuscript writing, editing and data collection; All authors have read and approved the final manuscript.

Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.

Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Gang Wang, MD, Chief Physician, Heart Center, The Third Central Hospital of Tianjin, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, No. 83 Jintang Road, Hedong District, Tianjin 300170, China. 15103172288@163.com

Received: June 5, 2022
Peer-review started: June 5, 2022
First decision: August 21, 2022
Revised: September 3, 2022
Accepted: September 27, 2022
Article in press: September 27, 2022
Published online: November 6, 2022
Processing time: 143 Days and 19.8 Hours

Abstract

BACKGROUND

Acute myocardial infarction (AMI) can be induced by several factors. However, AMI induced by Kounis syndrome (an allergic reaction) is extremely rare and is highly susceptible to misdiagnosis.

CASE SUMMARY

A 70-year-old man presented after suffering an allergic reaction that caused chest pain triggered upon eating ice cream. Troponin I was found to be elevated, and an electrocardiogram showed ST-segment elevation. The diagnosis was AMI. He underwent two coronary angiographies, with one intravascular ultrasound during hospitalization showing no evidence of atherosclerotic coronary artery disease. The final diagnosis was vasospastic myocardial infarction due to Kounis syndrome. The patient was then treated with hydrocortisone and intravenous antihistamines, and his chest pain symptoms resolved.

CONCLUSION

Allergic reactions (such as Kounis syndrome) can cause serious damage to the heart. Physicians should be alert to the consequences and avoid misdiagnosis.

Keywords: Acute myocardial infarction; Kounis syndrome; Allergic reaction; Case report; Acute coronary syndrome

Core Tip: Kounis syndrome is an acute coronary syndrome caused by an allergic reaction. However, Kounis syndrome is a rare cause of acute myocardial infarction. We describe one of these rare cases in which the patient’s troponin I levels were elevated and electrocardiogram showed ST-segment elevation. After a course of hydrocortisone and antihistamines, the patient’s chest pain was resolved.