title: Acute coronary syndrome secondary to clarithromycin: the first case and review of the literature.
abstract: Kounis syndrome (KS) is characterized by concurrent acute coronary syndrome and allergic reaction, in which acute inflammatory mediators cause spasm and/or erosion and rupture of coronary atheromatous plaque. In this report, we remind clinicians to consider KS in patients who are subjected to allergenic substances and demonstrate acute chest pain. A 36-year-old woman had chest pain, severe dyspnea, hypotension, and symmetrical negative T waves on the anterior leads during electrocardiography approximately two hours after the use of clarithromycin. KS was considered as a possible diagnosis based on the presentation. Laboratory tests revealed an elevated level of troponin I, suggesting myocardial infarction, and an elevated level of serum tryptase level, suggesting an allergic reaction. The patient promptly underwent coronary angiography, which revealed only plaques in all main coronary arteries without any obstructive lesion. To the best of our knowledge, we report herein the first case in the literature describing an association between clarithromycin and KS.
authors: Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey. drbilginmurat@hotmail.com.
authors: Murat
authors: M
authors: Bilgin
authors: Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors: Ahmet
authors: A
authors: Akyel
authors: Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors: Mehmet
authors: M
authors: Doğan
authors: Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors: Hamza
authors: H
authors: Sunman
authors: Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors: Ekrem
authors: E
authors: Yeter
mesh_terms: D054058:Acute Coronary Syndrome / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D017291:Clarithromycin / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004342:Drug Hypersensitivity / Q000150:complications / Q000175:diagnosis*; D004562:Electrocardiography; D005260:Female; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin