Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma
A 12-year-old male patient suffering from congenital glaucoma developed bradycardia, left ventricular failure, and hypotension after induction of anesthesia. Electrocardiography and echocardiography revealed a complete normalization of ECG and a complete spontaneous recovery in the cardiac function...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.676188/full |
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| author | Guglielmo Capponi Mattia Giovannini Ioanna Koniari Francesca Mori Chiara Rubino Gaia Spaziani Giovanni Battista Calabri Silvia Favilli Elio Novembre Giuseppe Indolfi Giuseppe Indolfi Luciano De Simone Sandra Trapani Sandra Trapani |
| author_facet | Guglielmo Capponi Mattia Giovannini Ioanna Koniari Francesca Mori Chiara Rubino Gaia Spaziani Giovanni Battista Calabri Silvia Favilli Elio Novembre Giuseppe Indolfi Giuseppe Indolfi Luciano De Simone Sandra Trapani Sandra Trapani |
| author_sort | Guglielmo Capponi |
| collection | DOAJ |
| description | A 12-year-old male patient suffering from congenital glaucoma developed bradycardia, left ventricular failure, and hypotension after induction of anesthesia. Electrocardiography and echocardiography revealed a complete normalization of ECG and a complete spontaneous recovery in the cardiac function 72 hours from the beginning of the clinical manifestations, while cardiac Magnetic Resonance Imaging was performed, and coronary Computed Tomography scan revealed a myocardial bridge of a tract of the left anterior descendent coronary artery. Diagnosis of Kounis syndrome (KS) was made, a relatively novel, under-recognized clinical condition, defined as the manifestation of an acute coronary syndrome accompanied by mast cell activation and platelet aggregation involving interrelated and interacting inflammatory cells in the setting of allergic, hypersensitivity, anaphylactic or anaphylactoid insults. We described one of the first pediatric cases of KS related to anesthetic medications. In children, this syndrome has been only described in isolated case reports or small case series. Thus, it appears critical to report new cases of KS in children to increase the awareness of this disease in pediatric healthcare workers so as to enhance its early recognition and optimal therapeutic strategy. Furthermore, it appears of paramount importance the implementation of universal guidelines accepted by allergology and cardiology societies, in order to standardize the management of pediatric and adult patients with KS. Finally, a close collaboration between pediatric allergists and cardiologists seems fundamental for an optimal multidisciplinary patient care. |
| first_indexed | 2024-12-17T19:40:47Z |
| format | Article |
| id | doaj.art-cace6e7d1ba3441ead5a9675866f6bad |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-17T19:40:47Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-cace6e7d1ba3441ead5a9675866f6bad2022-12-21T21:35:00ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-09-01810.3389/fcvm.2021.676188676188Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital GlaucomaGuglielmo Capponi0Mattia Giovannini1Ioanna Koniari2Francesca Mori3Chiara Rubino4Gaia Spaziani5Giovanni Battista Calabri6Silvia Favilli7Elio Novembre8Giuseppe Indolfi9Giuseppe Indolfi10Luciano De Simone11Sandra Trapani12Sandra Trapani13Cardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, ItalyAllergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, ItalyElectrophysiology and Device Department, University Hospital of South Manchester NHS Foundation Trust, Manchester, United KingdomAllergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, ItalyDepartment of Pediatrics, Meyer Children's Hospital, Florence, ItalyCardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, ItalyCardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, ItalyCardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, ItalyAllergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, ItalyDepartment of Pediatrics, Meyer Children's Hospital, Florence, ItalyDepartment of NEUROFARBA, Meyer Children's Hospital, University of Florence, Florence, ItalyCardiology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, ItalyDepartment of Pediatrics, Meyer Children's Hospital, Florence, ItalyDepartment of Health Sciences, Meyer Children's Hospital, University of Florence, Florence, ItalyA 12-year-old male patient suffering from congenital glaucoma developed bradycardia, left ventricular failure, and hypotension after induction of anesthesia. Electrocardiography and echocardiography revealed a complete normalization of ECG and a complete spontaneous recovery in the cardiac function 72 hours from the beginning of the clinical manifestations, while cardiac Magnetic Resonance Imaging was performed, and coronary Computed Tomography scan revealed a myocardial bridge of a tract of the left anterior descendent coronary artery. Diagnosis of Kounis syndrome (KS) was made, a relatively novel, under-recognized clinical condition, defined as the manifestation of an acute coronary syndrome accompanied by mast cell activation and platelet aggregation involving interrelated and interacting inflammatory cells in the setting of allergic, hypersensitivity, anaphylactic or anaphylactoid insults. We described one of the first pediatric cases of KS related to anesthetic medications. In children, this syndrome has been only described in isolated case reports or small case series. Thus, it appears critical to report new cases of KS in children to increase the awareness of this disease in pediatric healthcare workers so as to enhance its early recognition and optimal therapeutic strategy. Furthermore, it appears of paramount importance the implementation of universal guidelines accepted by allergology and cardiology societies, in order to standardize the management of pediatric and adult patients with KS. Finally, a close collaboration between pediatric allergists and cardiologists seems fundamental for an optimal multidisciplinary patient care.https://www.frontiersin.org/articles/10.3389/fcvm.2021.676188/fullKounis syndromeperioperativemidazolamsevofluranecoronary arterypediatrics |
| spellingShingle | Guglielmo Capponi Mattia Giovannini Ioanna Koniari Francesca Mori Chiara Rubino Gaia Spaziani Giovanni Battista Calabri Silvia Favilli Elio Novembre Giuseppe Indolfi Giuseppe Indolfi Luciano De Simone Sandra Trapani Sandra Trapani Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma Frontiers in Cardiovascular Medicine Kounis syndrome perioperative midazolam sevoflurane coronary artery pediatrics |
| title | Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma |
| title_full | Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma |
| title_fullStr | Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma |
| title_full_unstemmed | Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma |
| title_short | Case Report: Perioperative Kounis Syndrome in an Adolescent With Congenital Glaucoma |
| title_sort | case report perioperative kounis syndrome in an adolescent with congenital glaucoma |
| topic | Kounis syndrome perioperative midazolam sevoflurane coronary artery pediatrics |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.676188/full |
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