A Case of Kounis Syndrome Caused by Anaphylaxis During Surgery

Abstract

Kounis syndrome is a hypersensitivity coronary disorder associated with several triggers, such as drugs, foods, environmental, coronary stents and other factors. It was originally proposed by the Greek cardiologist Nicholas Kounis in 1991. Kounis syndrome is a life-threatening and challenging emergency disease, which is constantly being recognized and studied. It is a disease that is constantly being recognized and Kounis syndrome can be classified into three types, involving coronary artery spasm, plaque rupture or stent thrombosis respectively. Most patients with coronary artery spasm caused by allergies can recover completely after active treatment, and the prognosis is good. If not, it may cause severe myocardial damage and even myocardial infarction, which threatens the patient's life. In our case, a 56-year-old female patient was scheduled to undergo right pelvic resection. A few minutes after the start of intravenous succinylated gelatin infusion, she was experienced a decrease in heart rate, blood pressure, oxygen saturation and ST elevation on 2-lead. An anaphylactic reaction was suspected after rapid differential diagnosis and gradually recovered with treatment. In this context, a rapid differential diagnosis and a highly suspicious become essential, because the management of Kounis syndrome is different from the traditional acute coronary syndrome. Kounis syndrome requires simultaneous diagnosis and treatment of both allergic reaction and acute coronary syndrome based on their manifestations and risk factors. This case describes the onset, development, and recovery of Kounis syndrome in this patient in detail, and illustrates the classification, pathophysiology, and treatment of Kounis syndrome. It is hoped that through the management of this case, the occurrence of Kounis syndrome can be rapidly identified and treated accordingly so that avoiding disaster for patients.