From Wellens To Kounis Syndrome: An Unlucky Patient

  • Ossama Maadarani Internal Medicine Department, Ahmadi Hospital - Kuwait Oil Company, Al Ahmadi, Kuwait
  • Zouheir Bitar Internal Medicine Department, Ahmadi Hospital - Kuwait Oil Company, Al Ahmadi, Kuwait
  • Sania Shoeb Internal Medicine Department, Al Salam Hospital, Kuwait
  • Jadan Alsaddah Department of Cardiology, Chest Diseases Hospital, Kuwait

Keywords

Contrast media, Kounis syndrome, Wellens syndrome

Abstract

Wellens syndrome (WS) is identified by ECG changes in the precordial leads after resolution of angina chest pain. WS indicates critical stenosis of the proximal left anterior descending (LAD) artery. On the other hand, Kounis syndrome (KS) is an allergic reaction to various substances resulting in acute coronary syndrome. Contrast media can trigger the allergic reaction associated with KS. We describe a patient with WS who developed an allergic reaction to contrast media after percutaneous coronary intervention and experienced recurren myocardial infarction on re-exposure.

VIEW THE ENTIRE ARTICLE

References

  • Kogias JS, Sideris SK, Anifadis SK. Kounis syndrome associated with hypersensitivity to hymenoptera sting. Int J Cardiol 2007;114:252–255.

  • Kounis NG, Zavras GM. Histamine-induced coronary artery spasm: the concept of allergic angina. Br J Clin Pract 1991;45:121–128.

  • Kounis NG. Kounis syndrome (allergic angina and allergic myocardial infarction): a natural paradigm? Int J Cardiol 2006;110:7–14.

  • Sakata V, Komamura K, Hirayama A, Nanto S, Kitakaze M, Hori M, et al. Elevation of plasma histamine concentration in the coronary circulation in patients with variant angina. Am J Cardiol 1996;77:1121–1126.

  • Kounis GN, Kounis SA, Hahalis G, Kounis NG. Coronary artery spasm associated with eosinophilia: another manifestation of Kounis syndrome? Heart Lung Circ 2009;18(2):163– 164.

  • Shibuya K, Kasama S, Funada R, Katoh H, Tsushima Y. Kounis syndrome induced by contrast media: a case report and review of literature. Eur J Radiol Open 2019;6:91–96.

  • Abdelghany M, Subedi R, Shah R, Kozman H. Kounis syndrome: a review article on epidemiology, diagnostic findings, management and complications of allergic acute coronary
    syndrome. Int J Cardiol 2017;232:1–4.

  • Kounis NG. Coronary hypersensitivity disorder: the Kounis syndrome. Clin Ther 2013;35(5):563–571.

  • Nikolaidis LA, Kounis NG, Gradman AH. Allergic angina and allergic myocardial infarction: a new twist on an old syndrome. Can J Cardiol 2002;18(5):508–511.

  • Takagi S, Goto Y, Hirose E, Terashima M, Sakuragi S, Suzuki S, et al. Successful treatment of refractory vasospastic angina with corticosteroids: coronary arterial hyperactivity caused by local inflammation? Circ J 2004;68:17–22.

  • Sebaldt RJ, Sheller JR, Oates JA, Roberts LJ, Fitzgerald GA. Inhibition of eicosanoid biosynthesis by glucocorticoid in humans. Proc Natl Acad Sci USA 1990;87:6974–6978.
  • Published: 2020-06-05

    Issue: Vol 7 No 9 (view)

    Section: Articles

    How to cite:
    1.
    Maadarani O, Bitar Z, Shoeb S, Alsaddah J. From Wellens To Kounis Syndrome: An Unlucky Patient. EJCRIM [Internet]. 2020Jun.5 [cited 2020Sep.24];7(9). Available from: https://ejcrim.com/index.php/EJCRIM/article/view/1689