https://journals.ku.edu/kjm/article/download/21486/20178
KANSAS JOURNAL of MEDICINE, Published online April 26, 2024. https://doi.org/10.17161/kjm.vol17.21486
Justin Helberg, Eric Acosta (Hays Medical Center, Hays, KS; Garden City Medical Center, Garden City, KS)
INTRODUCTION
Kounis Syndrome, also known as “allergic angina” and “allergic myocardial infarction,” is a rare but increasingly recognized clinical entity characterized by acute coronary events triggered by allergic reactions. It was first described in 1991.1 This syndrome encompasses a spectrum of acute coronary conditions, including angina, myocardial infarction, and stent thrombosis, all of which can be induced by various allergic insults. Assessing the epidemiology of Kounis Syndrome poses challenges. In patients with signs and symptoms suggestive of myocardial infarction, approximately 15% exhibit no obstructive coronary artery disease. Among this group, 30-40% are believed to be associated with coronary artery vasospasm.
Kounis Syndrome is believed to result from activation of mast cells and basophils during allergic reactions. These activated cells release inflammatory mediators, including histamine, tryptase, leukotrienes, and cytokines, which can lead to coronary vasospasm, endothelial dysfunction, and platelet activation. This process may result in myocardial ischemia and, in severe cases, infarction.
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