Korean J Anesthesiol.  2014 Dec;67(6):412-415. 10.4097/kjae.2014.67.6.412.

Sudden cardiovascular collapse caused by severe anaphylaxis after cisatracurium use: a case report

• Yoon SH
• Bang JY
• Seo H
• Song JG

• KMID: 2425276
• DOI: http://doi.org/10.4097/kjae.2014.67.6.412

Abstract

Kounis syndrome is an acute coronary syndrome concurrently occurs with allergic or hypersensitivity reactions. In patient with this syndrome, inflammatory mediators released due to an allergic reaction implicate to induce coronary artery spasm and atheromatous plaque rupture. We describe a patient with coronary artery disease who developed acute perioperative myocardial infarction leading to cardiac arrest after the anaphylactic reaction to cisatracurium, which led to a suspicion of Kounis syndrome. Anesthesiologists should be aware that anaphylaxis or allergic reactions can progress to acute coronary syndrome, thereby significantly change the course of the disease.

Keyword

Anaphylaxis; Cisatracurium; Kounis syndrome; Myocardial infarction

MeSH Terms

Acute Coronary Syndrome
Anaphylaxis*
Coronary Artery Disease
Coronary Vessels
Heart Arrest
Humans
Hypersensitivity
Myocardial Infarction
Rupture
Spasm