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Case Reports
. 2023 Sep 20;15(9):e45635.
doi: 10.7759/cureus.45635. eCollection 2023 Sep.

A Complicated Case of Aspirin-Exacerbated Respiratory Disease With Kounis Syndrome

Krista M Shaw  1 , Brittanie I Neaves  2 , Hayden A Springer  1 , Christopher A Coop  2
Affiliations
Case Reports

A Complicated Case of Aspirin-Exacerbated Respiratory Disease With Kounis Syndrome

Krista M Shaw et al. Cureus. .

Abstract

Kounis syndrome is angina or acute coronary syndrome caused by mast cell degranulation and inflammatory cell activation. We present a case of a patient with underlying aspirin-exacerbated respiratory disease (AERD) and previous anaphylaxis to aspirin. The patient underwent aspirin desensitization and was then treated with high-dose aspirin. Unfortunately, he developed recurrent angina and myocardial infarction (MI). Numerous left heart catheterizations revealed vasospasms as the etiology of his MIs; however, therapy with increasing doses of vasodilators yielded no improvement in the patient's condition. Ultimately the patient's aspirin was discontinued and he had no recurrence of angina or MI.

Keywords: aerd; allergic acute coronary syndrome; allergic myocardial infarction; aspirin hypersensitivity; aspirin-exacerbated respiratory disease; kounis syndrome.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. A timeline of the patient’s aspirin-associated respiratory and cardiac events.
NSTEMI: non-ST-elevation myocardial infarction; STEMI: ST-elevation myocardial infarction; VF: ventricular fibrillation; AICD: automatic implantable cardioverter defibrillator; MI: myocardial infarction
See this image and copyright information in PMC

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