|PIOTR SOBAŃSKI, WŁADYSŁAW SINKIEWICZ, PIOTR MAŁYSZKA, ZBIGNIEW BARTUZI |
Myocardial ischemia evolving during allergic reaction is caused mostly by constriction of the coronary artery. This syndrome (Kounis syndrome) is seen in patients with, but also without atherosclerotic changes in coronaries studied by angiography. Endothelial dysfunction constitutes the underlying mechanism responsible for arterial spasm instead of the expected vasorelaxation secondary to allergic mediators release. The authors describe an angiographically proven case of myocardial infarction which evolved from the anaphylactic reaction to wasp sting. Secondary to myocardial infarction, the patient developed significant left ventricular systolic dysfunction. Despite that left ventricle damage constitutes some counterindication to specific immunotherapy, the latter was performed without any undesirable circulatory side effects. In this paper we discuss mechanisms responsible for myocardial ischemia secondary to allergic reactions. The specificity of heart disease treatment in patient with allergic history, especially during immunotherapy has been underlined.
keywords: alergia na jad owadów, zawał mięśnia sercowego, swoista immunoterapia, hymenoptera venom allergy, myocardial infarction, specific immunotherapy
pages: from 218 to 222
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