Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Apr 23;32(2):253-255.
doi: 10.1080/08998280.2019.1581319. eCollection 2019 Apr.

Kounis syndrome secondary to gadolinium contrast agent

Affiliations
Case Reports

Kounis syndrome secondary to gadolinium contrast agent

Waiel Abusnina et al. Proc (Bayl Univ Med Cent). .

Abstract

Cases of coronary artery spasm secondary to contrast agent use are rarely reported. Herein, we report the case of a 53-year-old woman who developed chest pain, dyspnea, and bradycardia and quickly become unresponsive after magnetic resonance imaging of the brain. A heart monitor showed ST elevation, and an electrocardiogram showed ST elevations in leads II, III, aVF, V3, and V4 and ST segment depression in lead I. Urgent left heart catheterization revealed no evidence of obstructive coronary artery disease or pulmonary embolism. A few days later, she was discharged from the hospital with no symptoms. A type I variant of Kounis syndrome was diagnosed.

Keywords: Acute coronary syndrome; Kounis syndrome; allergy; contrast medium–induced coronary vasospasm; coronary hypersensitivity disorder.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Electrocardiogram showing ST elevations in leads II, III, aVF, V3, and V4 and ST segment depression in lead I.
Figure 2.
Figure 2.
Coronary angiogram showing (a) mild disease in the middle right coronary artery and (b) patent coronary arteries with no evidence of stenosis.
Figure 3.
Figure 3.
(a) Right and (b) left coronary pulmonary angiography showing no evidence of pulmonary embolism.
Figure 4.
Figure 4.
Electrocardiogram demonstrating resolution of ST elevations.

Similar articles

Cited by

References

    1. Kounis NG, Zavras GM. Histamine-induced coronary artery spasm: the concept of allergic angina. Br J Clin Pract. 1991;45:121–128. - PubMed
    1. Scherbak D, Lazkani M, Sparacino N, Loli A. Kounis syndrome: a stinging case of ST-elevation myocardial infarction. Heart Lung Circ. 2015;24:e48–e50. doi:10.1016/j.hlc.2014.11.026. - DOI - PubMed
    1. Pfister CW, Plice SG. Acute myocardial infarction during a prolonged allergic reaction to penicillin. Am Heart J. 1950;40:945–947. - PubMed
    1. Gázquez V, Dalmau G, Gaig P, Gómez C, Navarro S, Mercé J. Kounis syndrome: report of 5 cases. J Investig Allergol Clin Immunol, 2010;20:162–165. - PubMed
    1. Helbling A, Hurni T, Mueller UR, Pichler WJ. Incidence of anaphylaxis with circulatory symptoms: a study over a 3-year period comprising 940,000 inhabitants of the Swiss Canton Bern. Clin Exp Allergy. 2004;34:285–290. doi:10.1111/j.1365-2222.2004.01882.x. - DOI - PubMed

Publication types

LinkOut - more resources