Key result
Intravenous vancomycin triggers Kounis syndrome with coronary artery vasospasm and myocardial infarction.
Why the study?
Kounis syndrome is an important but underrecognized cause of myocardial infarction due to allergic coronary artery vasospasm triggered by agents such as vancomycin.
Case Report (n=1)
Alerts clinicians to possible vancomycin-induced Kounis syndrome; extends documented triggers of allergic coronary vasospasm.
We describe a case of Kounis syndrome, an allergic reaction causing coronary artery vasospasm, triggered by a vancomycin infusion, in a healthy 32-year-old man. The patient initially presented with an inguinal abscess requiring intravenous vancomycin. During his third infusion, he developed typical chest pain that resolved with cessation of the infusion. Troponin was elevated, and electrocardiogram showed ST elevation, prompting emergent cardiac catheterization that demonstrated normal coronary arteries. The cause of the myocardial infarction was consistent with Kounis syndrome. Diagnosis of Kounis syndrome is important, as prompt cessation of the offending agent is a priority to reduce further cardiac injury.
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Gagnon et al. (2021) conducted a case report in Inguinal abscess (developed Kounis syndrome) (n=1). Vancomycin was evaluated on Development of Kounis syndrome (allergic coronary artery vasospasm causing myocardial infarction). Intravenous vancomycin triggered Kounis syndrome, resulting in coronary artery vasospasm and myocardial infarction in a 32-year-old man.
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