Cefuroxime-induced coronary artery spasm manifesting as Kounis syndrome.
Allergic angina and allergic myocardial infarction (Kounis syndrome) occurring during the course of a drug-induced allergic reaction in the absence of angiographically stenosed coronary arteries, is rare in clinical practice. This paper reports the case of a 70-year-old woman with no significant risk factors for coronary artery disease who developed coronary artery spasm after intravenous injection of cefuroxime. A subsequent coronary angiogram revealed normal coronary arteries (type I variant of the syndrome). The allergic reaction following cefuroxime administration seems to have triggered the development of coronary artery spasm. Susceptible individuals expressing an amplified mast cell degranulation effect may be more vulnerable to coronary artery spasm. The clinical implications of this syndrome are also discussed.
Department of Cardiology, University of Patras, Medical School, Patras, Greece.
Andreas
A
Mazarakis
Constantinos M
CM
Koutsojannis
Nicholas G
NG
Kounis
Dimitrios
D
Alexopoulos
D000368:Aged; D000787:Angina Pectoris / Q000139:chemically induced* / Q000276:immunology / Q000503:physiopathology; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002444:Cefuroxime / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000276:immunology / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D013577:Syndrome
D000900:Anti-Bacterial Agents; D002444:Cefuroxime