Key result
Iodinated contrast media triggers life-threatening Kounis syndrome with severe vasospasm and anaphylactic shock.
Why the study?
Kounis syndrome induced by iodinated contrast media during coronary angiogram presents a life-threatening clinical dilemma requiring prompt recognition and management.
Case Report (n=1)
No
Highlights the importance of recognizing Kounis syndrome induced by iodinated contrast media during coronary angiography to avoid further contrast administration and manage the life-threatening vasospasm.
May prompt consideration of Kounis syndrome in contrast reactions during angiography; leaves open incidence and prevention strategies.
Kounis syndrome (KS) is a well-documented hypersensitivity vasospastic reaction induced by a variety of triggers. Clinical presentation ranges from non-specific symptoms such as dizziness and nausea to myocardial infarction. Many cases of KS were reported after the use of iodinated contrast media, mainly during radiological procedures. This report describes the case of a 46-year-old man developing coronary vasospasm and anaphylactic shock at the end of percutaneous coronary intervention. Occurrence of such pathology while performing coronary angiogram is a tricky situation for the invasive cardiologist. It requires recognising a rare syndrome and interrupting the procedure to avoid extra use of contrast media even in presence of severe coronary lesions due to vasospasm. Every interventionalist should be aware of such a presentation to recognise and react promptly when facing a potentially life-threatening clinical dilemma.
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Bonnet et al. (2022) conducted a case report in Kounis syndrome (n=1). Iodinated contrast media was evaluated. Exposure to iodinated contrast media during a coronary angiogram triggered Kounis syndrome, presenting as life-threatening coronary vasospasm and anaphylactic shock in a 46-year-old man.
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