Key result
Severe status asthmaticus triggers type 1 Kounis syndrome presenting as STEMI and cardiogenic shock.
Why the study?
Severe status asthmaticus may precipitate type 1 Kounis syndrome causing coronary vasospasm that mimics obstructive coronary artery disease angiographically.
Case Report (n=1)
Severe status asthmaticus can precipitate type 1 Kounis syndrome with severe vasospasm mimicking obstructive coronary disease, which must be correctly identified to avoid inappropriate revascularization.
May prompt consideration of allergic vasospasm in status asthmaticus with apparent STEMI; hypothesis-generating for Kounis syndrome incidence and management.
BACKGROUND: Kounis syndrome is an allergic acute coronary syndrome that may produce multivessel coronary vasospasm, angiographically mimicking obstructive coronary artery disease without atherosclerosis. CASE SUMMARY: A 46-year-old atopic man admitted for status asthmaticus developed inferior ST-segment elevation myocardial infarction, complete heart block, ventricular fibrillation, and cardiogenic shock on hospital day 3. Emergent angiography revealed multivessel vasospasm with apparent stenoses up to 90%. Cardiac magnetic resonance showed ischemic injury without myocarditis. Repeat angiography on hospital day 20 demonstrated nonobstructive coronary artery disease, supporting vasospasm-mediated coronary pseudostenosis. DISCUSSION: Severe status asthmaticus may precipitate type 1 Kounis syndrome. Apparent coronary stenoses during active vasospasm may represent vasospasm-mediated pseudostenosis and should be reassessed before revascularization is considered. TAKE-HOME MESSAGES: Severe status asthmaticus may precipitate type 1 Kounis syndrome with ST-segment elevation myocardial infarction, malignant arrhythmias, and cardiogenic shock despite nonobstructive coronary arteries. Apparent coronary stenoses during active vasospasm may represent vasospasm-mediated pseudostenosis and should be reassessed before revascularization is pursued.
No takes yet. Share an insight, caveat, or question.
Yu et al. (2026) conducted a case report in Type 1 Kounis Syndrome / Status Asthmaticus (n=1). Status asthmaticus was evaluated. Severe status asthmaticus in a 46-year-old man precipitated type 1 Kounis syndrome with STEMI and cardiogenic shock, presenting as vasospasm-mediated coronary pseudostenosis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: