Plaque rupture and neovascularisation detected with optical coherence tomography in a case of Kounis syndrome.

在 Kounis 综合征的情况下 ， 用光学相干断层扫描检测到的斑块破裂和新血管化。

• 发表时间: Oct 2022 21
• 来源期刊: BMJ Case Rep
• DOI: 10.1136/bcr-2022-251820
• PMID: 36270738
• 文章类型: Case Reports
• 作者列表: Katsuda S,Kaku B

关键词: interventional cardiology; ischaemic heart disease

Mesh: Female; Humans; Kounis Syndrome / complications; Tomography, Optical Coherence / methods; Cefazolin; Plaque, Atherosclerotic / complications diagnostic imaging; Acute Coronary Syndrome / diagnostic imaging etiology

Abstract

Kounis syndrome is an allergic acute coronary syndrome (ACS) characterised by coronary artery spasm, plaque erosion/rupture or stent thrombosis caused by mast cell and other interacting cell activation. Although intracoronary imaging modalities can detect those ACS mechanisms, Kounis syndrome due to plaque rupture has rarely been reported using intracoronary imaging. We present the case of a woman in her 70s who developed Kounis syndrome as a result of plaque rupture detected with optical coherence tomography (OCT). She had non-ST-segment elevation ACS as a result of anaphylaxis to cefazolin. Coronary angiography revealed severe stenosis in the left anterior descending artery; angiographically undetectable plaque rupture was detected using OCT. OCT also revealed intraplaque neovascularisation, suggesting that the culprit plaque had been vulnerable. OCT can aid in understanding the underlying mechanisms of Kounis syndrome.

摘要

Kounis综合征是一种过敏性急性冠状动脉综合征（ACS），以冠状动脉痉挛为特征，肥大细胞和其他相互作用细胞活化引起的斑块侵蚀/破裂或支架血栓形成。尽管冠状动脉成像模式可以检测到这些ACS机制，冠状动脉成像很少报道由于斑块破裂引起的Kounis综合征。我们介绍了一名70多岁的女性，该女性因光学相干断层扫描（OCT）检测到斑块破裂而发展为库尼斯综合征。由于对头孢唑啉的过敏反应，她患有非ST段抬高的ACS。冠状动脉造影显示左前降支严重狭窄；使用OCT检测到血管造影无法检测到的斑块破裂。OCT还显示斑块内新生血管形成，这表明罪犯的斑块很脆弱。OCT可以帮助理解Kounis综合征的潜在机制。