After Administration of Intravenous Epinephrine for bee Sting-induced Anaphylaxis: Kounis Syndrome or Epinephrine Effect?
摘要To the Editor: In the very important report published in Chinese Medical Journal,[1] a 50-year-old male patient, stented with a bare metal stent followed by 3 overlapping drug-eluting stents, developed anaphylactic reaction following a bee sting that was treated with intravenous 0.1 mg epinephrine at a 1:100,000 together with intravenous methylprednisolone, chlorpheniramine maleate, and ranitidine.He developed, immediately after, an anterior wall myocardial infarction, and subsequent coronary arteriography revealed total occlusion in the proximal left anterior descending stent and 90% stenosis with tissue growth in the mid-stent.The authors concluded that the acute myocardial infarction occurred due to acute stent thrombosis caused by exogenous epinephrine administration.This report, however, raises important questions related to the cause and pathophysiology of these events.
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