JACC. Case reports · 2026
Type 1 Kounis Syndrome Presenting as Coronary Pseudostenosis During Status Asthmaticus.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Yu Allen M, Mohmand Billal, Li Anita Z, Jehangir Qasim, Bai Rong, Gopalan Radha S, Rizik David G, Sorajja Paul, Mookadam Farouk
Аннотация
BACKGROUND: Kounis syndrome is an allergic acute coronary syndrome that may produce multivessel coronary vasospasm, angiographically mimicking obstructive coronary artery disease without atherosclerosis.
CASE SUMMARY: A 46-year-old atopic man admitted for status asthmaticus developed inferior ST-segment elevation myocardial infarction, complete heart block, ventricular fibrillation, and cardiogenic shock on hospital day 3. Emergent angiography revealed multivessel vasospasm with apparent stenoses up to 90%. Cardiac magnetic resonance showed ischemic injury without myocarditis. Repeat angiography on hospital day 20 demonstrated nonobstructive coronary artery disease, supporting vasospasm-mediated coronary pseudostenosis.
DISCUSSION: Severe status asthmaticus may precipitate type 1 Kounis syndrome. Apparent coronary stenoses during active vasospasm may represent vasospasm-mediated pseudostenosis and should be reassessed before revascularization is considered.
TAKE-HOME MESSAGES: Severe status asthmaticus may precipitate type 1 Kounis syndrome with ST-segment elevation myocardial infarction, malignant arrhythmias, and cardiogenic shock despite nonobstructive coronary arteries. Apparent coronary stenoses during active vasospasm may represent vasospasm-mediated pseudostenosis and should be reassessed before revascularization is pursued.
CASE SUMMARY: A 46-year-old atopic man admitted for status asthmaticus developed inferior ST-segment elevation myocardial infarction, complete heart block, ventricular fibrillation, and cardiogenic shock on hospital day 3. Emergent angiography revealed multivessel vasospasm with apparent stenoses up to 90%. Cardiac magnetic resonance showed ischemic injury without myocarditis. Repeat angiography on hospital day 20 demonstrated nonobstructive coronary artery disease, supporting vasospasm-mediated coronary pseudostenosis.
DISCUSSION: Severe status asthmaticus may precipitate type 1 Kounis syndrome. Apparent coronary stenoses during active vasospasm may represent vasospasm-mediated pseudostenosis and should be reassessed before revascularization is considered.
TAKE-HOME MESSAGES: Severe status asthmaticus may precipitate type 1 Kounis syndrome with ST-segment elevation myocardial infarction, malignant arrhythmias, and cardiogenic shock despite nonobstructive coronary arteries. Apparent coronary stenoses during active vasospasm may represent vasospasm-mediated pseudostenosis and should be reassessed before revascularization is pursued.