Recurrent Coronary Vasospasm: A Case of Kounis Syndrome from Anaphylaxis to Contrast Dye

Methodist Debakey Cardiovasc J. 2022 Jun 28;18(1):29-36. doi: 10.14797/mdcvj.1084. eCollection 2022.

Abstract

Kounis syndrome is characterized by acute coronary syndrome due to coronary vasospasm or thrombosis following exposure to an allergic stimulus. The presentation can be compounded by cardiovascular collapse due to cardiogenic shock from coronary vasospasm and associated vasodilatory shock from anaphylaxis. A high index of suspicion is crucial for prompt initiation of treatment, which focuses on managing the allergic or anaphylactic process. Here we present a case of coronary vasospasm and anaphylactic shock due to contrast dye exposure during percutaneous coronary intervention of an unstable coronary lesion and its associated diagnostic and therapeutic challenges.

Keywords: Kounis syndrome; anaphylaxis; contrast dye; coronary artery disease; hypersensitivity; vasospasm.

Publication types

  • Case Reports

MeSH terms

  • Acute Coronary Syndrome* / diagnostic imaging
  • Acute Coronary Syndrome* / therapy
  • Anaphylaxis* / chemically induced
  • Anaphylaxis* / diagnosis
  • Anaphylaxis* / therapy
  • Coronary Vasospasm* / chemically induced
  • Coronary Vasospasm* / diagnostic imaging
  • Coronary Vasospasm* / therapy
  • Humans
  • Kounis Syndrome* / diagnosis
  • Kounis Syndrome* / etiology
  • Kounis Syndrome* / therapy
  • Shock, Cardiogenic