Epinephrine and the paradox of Kounis syndrome: a case series and review of management.

IF 0.8 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
European Heart Journal: Case Reports Pub Date : 2025-09-03 eCollection Date: 2025-09-01 DOI:10.1093/ehjcr/ytaf414
Mohammad Hamideh, Alec Rhodes, Aswin Srinivasan, Shudipan Chakraborty, Christopher Hawkins, Aakash Kumar, Hafez Golzarian
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引用次数: 0

Abstract

Background: Epinephrine, the primary treatment for anaphylaxis, may paradoxically worsen underlying myocardial ischaemia due to its vasoconstrictive effects and potential to trigger vasospasm during an inflammatory response.

Case summary: We present two cases of Kounis syndrome-one in a patient who developed Prinzmetal angina after exposure to shellfish and another who experienced cardiac arrest after receiving intramuscular epinephrine for an anaphylactic reaction to a wasp sting.

Discussion: These cases emphasize the potential for anaphylaxis to precipitate acute coronary syndrome which can paradoxically be exacerbated by the routine administration of epinephrine in susceptible individuals, underscoring the importance of heightened vigilance and consideration of alternative therapies when Kounis syndrome is suspected.

肾上腺素与库尼斯综合征的悖论:一个病例系列和管理回顾。
背景:肾上腺素作为过敏性反应的主要治疗药物,由于其血管收缩作用和在炎症反应中引发血管痉挛的潜力,可能会矛盾地加重潜在的心肌缺血。病例总结:我们报告了两个Kounis综合征的病例,其中一个患者在接触贝类后出现了Prinzmetal心绞痛,另一个患者在对黄蜂蜇伤产生过敏反应后接受肌肉注射肾上腺素后出现了心脏骤停。讨论:这些病例强调了过敏反应诱发急性冠状动脉综合征的可能性,易感个体常规使用肾上腺素反而会加重急性冠状动脉综合征,强调了当怀疑有Kounis综合征时提高警惕和考虑替代治疗的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European Heart Journal: Case Reports
European Heart Journal: Case Reports Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.30
自引率
10.00%
发文量
451
审稿时长
14 weeks
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