Should beta‐blockers be continued as a treatment for myocardial infarction in the case of Kounis syndrome?
Mari Amino, Tomokazu Fukushima, Atsushi Uehata, Chiemi Nishikawa, Seiji Morita, Yoshihide Nakagawa, Tsutomu Murakami, Koichiro Yoshioka, Yuji Ikari
Abstract
A 71-year-old male patient reported to our hospital with anaphylactic shock, and the following two issues were focused in this case. First, he was resistant to adrenaline because of taking beta-blocker, and shock was repeated until glucagon administration was initiated. Second, he developed acute coronary syndrome. Two mechanisms contributing to Kounis syndrome were differentiated: 1) adrenaline induced coronary spasm and platelet activation or 2) a mismatch between oxygen supply and demand due to an allergic reaction. Beta-blocker therapy was discontinued because his cardiac function was preserved. Secondary preventive beta-blockers in recovering myocardial infarction with severe anaphylaxis history should be carefully considered.