Early stent thrombosis in Kounis syndrome - a case report Kunisov sindrom i rana tromboza stenta

被引:0
|
作者
Kostic, Tomislav [1 ,2 ]
Perisic, Zoran [1 ,2 ]
Maricic, Bojan [1 ]
Apostolovic, Svetlana [1 ,2 ]
Stanojevic, Dragana [1 ]
Koracevic, Goran [1 ,2 ]
Dakic, Sonja [1 ,2 ]
Bozinovic, Nenad [1 ,2 ]
Kostic, Katarina [1 ]
Milosevic, Jelena [1 ]
Lazarevic, Mihajlo [1 ]
机构
[1] Univ Clin Ctr Nis, Clin Cardiol, Bulevar dr Zorana Dindica 48, Nish 18000, Serbia
[2] Univ Nis, Fac Med Nis, Nish, Serbia
关键词
angioplasty; balloon; coronary angiography; coronary disease; hypersensitivity; kounis syndrome; ELUTING STENT; HYPERSENSITIVITY; RESTENOSIS; TWIST;
D O I
10.2298/VSP230424037K
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction. Kounis syndrome is a simultaneous manifestation of acute coronary syndrome and conditions associated with mast cell activation, such as allergies or anaphylactic reactions. We present early stent thrombosis in a female with an atopic constitution without previous atherosclerosis of coronary arteries. Case report. A 50 -year -old woman with typical anginal pain was admitted to the Clinic for Cardiology, University Clinical Cente r Ni & scaron;. A few hours earlier, she had passed by a linden tree in bloom. She immediately felt chest pain, paresthesia and numbness in her left arm throat tightness, heaviness of the tongue, and swelling of the lips. The symptoms disappeared for 60 min after taking 10 mg of loratadine, but then they recurred. On the electrocardiographic (ECG) findings, 30 minutes after admission, ST elevation was seen in leads D2, D3, aVF, and V6. She underwent an emergency percutaneous coronary intervention procedure. Occlusive thrombosis was seen in the ostium of the left anterior descending (LAD) coronary artery. A sirolimus -coated stent was placed and thrombolysis in myocardial infarction (TIMI) 3 flow was obtained. A few hours after the intervention, the patient reported a new onset of chest pain followed by ventricular fibrillation (VF), DC shock, and the occurrence of new ST-segment elevation in aVR and V1 -V3 on the ECG. Repeated angiography showed acute in-stent thrombotic occlusion. Balloon angioplasty was performed, which restored TIMI 3 flow in LAD coronary artery. Anticoagulant and corticosteroid therapy was administered. Three days after the intervention, optical coherence tomography imaging was performed, which showed good stent expansion and apposition, without atherosclerosis and thrombosis. Conclusion. Coronary angiography proved type I Kounis syndrome after exposure to an allergen, and type III Kounis syndrome developed shortly after stent placement when acute in-stent thrombosis occurred. Newly described causes of acute and subacute stent thrombosis in type III Kounis syndrome are stent-associated hypersensitivity reactions.
引用
收藏
页码:1034 / 1038
页数:5
相关论文
共 50 条
  • [32] Acute anterior myocardial infarction due to stent thrombosis after mushroom consumption: A case of Kounis type III syndrome
    Michas, George
    Stougiannos, Pavlos
    Thomopoulos, Thomas
    Grigoriou, Konstantinos
    Blazakis, George
    Kaplanis, Ioannis
    Gavrielatos, Gerasimos
    Trikas, Athanasios
    HELLENIC JOURNAL OF CARDIOLOGY, 2017, 58 (05) : 378 - 380
  • [34] Type I Kounis syndrome in a young woman without chest pain: a case report
    Nanyoshi, Miki
    Hayashi, Tomohiro
    Sugimoto, Ryu
    Nishisaki, Hogara
    Kenzaka, Tsuneaki
    BMC CARDIOVASCULAR DISORDERS, 2024, 24 (01):
  • [36] Coronary Artery Thromboses, Stent Thrombosis and Antiphospholipid Antibody Syndrome: Case Report
    Correia, Augusto Ferreira
    Oliveira, Dinaldo Cavalcanti
    Sanctos, Marcio
    CARDIOLOGY RESEARCH, 2018, 9 (02) : 129 - 132
  • [37] Kounis syndrome leading to triple-vessel coronary artery ischaemia due to simultaneous coronary spasm, plaque erosion, and multiple stent thrombosis: a case report
    Yamamoto, Hiroyuki
    Otake, Hiromasa
    Tanimura, Kosuke
    Hirata, Ken-ichi
    EUROPEAN HEART JOURNAL-CASE REPORTS, 2022, 6 (05)
  • [38] A CASE REPORT OF ACUTE CORONARY SYNDROME: VERY LATE STENT THROMBOSIS DUE TO MAJOR STENT MALAPPOSITION
    Buonpane, Angela
    Ricchiuto, Alfredo
    Lombardi, Marco
    Maino, Alessandro
    Bianchini, Emiliano
    Busco, Marco
    Burzotta, Francesco
    Vergallo, Rocco
    EUROPEAN HEART JOURNAL SUPPLEMENTS, 2022, 24
  • [39] Early Use of ECMO for Refractory Kounis Syndrome Concealed by General Anesthesia-A Case Report
    Yu, Ho Kyung
    Park, Miyeong
    Lee, Soo Hee
    Woo, Jung-Woo
    Kang, Dong-Hoon
    Byun, Joung Hun
    Ok, Seong-Ho
    MEDICINA-LITHUANIA, 2022, 58 (06):
  • [40] Type I Kounis syndrome induced by COVID-19 vaccination in China: a case report
    Yubing Deng
    Zhujun Peng
    Xiaoping Peng
    BMC Cardiovascular Disorders, 23