Wiener klinische Wochenschrift

, Volume 129, Issue 13–14, pp 509–511 | Cite as

Acute myocardial infarction in a patient suffering from penicillin-induced laryngeal edema

Kounis syndrome aggravated by adrenaline
  • Mahmut YesinEmail author
  • Macit Kalçık
  • Mustafa Ozan Gürsoy
  • Süleyman Karakoyun
  • Metin Çağdaş
  • Mehmet Özkan
case report


Kounis syndrome or allergic angina is defined as the coincidental occurrence of chest pain and allergic reactions accompanied by clinical and laboratory findings of classical angina pectoris. It is triggered by the action of potent vasoactive and inflammatory mediators, which are released from the mast cells during the allergic reaction. Epinephrine is a life-saving medication in anaphylaxis; however, it can aggravate ischemia and induce coronary vasospasm and arrhythmias. Here, we present a patient with Kounis syndrome that was caused by intramuscular injection of procaine penicillin G, and in whom epinephrine administration for treatment of laryngeal edema had provoked severe myocardial ischemia.


Acute myocardial infarction Allergic angina Penicillin allergy Kounis syndrome Epinephrine 



No funding.

Conflict of interest

M. Yesin, M. Kalçık, M.O. Gürsoy, S. Karakoyun, M. Çağdaş, and M. Ozkan declare that they have no competing interests.

Supplementary material

Video 1. Transthoracic echocardiography (parasternal short axis) shows segmental wall motion abnormality of inferolateral segments.


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Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  • Mahmut Yesin
    • 1
    Email author
  • Macit Kalçık
    • 3
  • Mustafa Ozan Gürsoy
    • 4
  • Süleyman Karakoyun
    • 5
  • Metin Çağdaş
    • 5
  • Mehmet Özkan
    • 2
    • 6
  1. 1.Department of CardiologyKars Harakani State HospitalKarsTurkey
  2. 2.Department of CardiologyKosuyolu Kartal Heart Training and Research HospitalIstanbulTurkey
  3. 3.Department of Cardiologyİskilip Atıf Hoca State HospitalÇorumTurkey
  4. 4.Department of CardiologyGaziemir State HospitalİzmirTurkey
  5. 5.Department of CardiologyKars Kafkas University, Faculty of MedicineKarsTurkey
  6. 6.Division of Health SciencesUniversity of ArdahanArdahanTurkey

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