Takotsubo cardiomyopathy associated with Kounis syndrome: A clinical case of the “ATAK complex”

Davide Margonato, Raffaele Abete, Gabriella Di Giovine, Pietro Delfino, Massimiliano Grillo, Simone Mazzetti, Daniele Poggio, Jessica Rossi, Toufic Khouri, Andrea Mortara

Research output: Contribution to journalArticle

Abstract

A 60-year-old female developed cardiac arrest after experiencing an anaphylactic shock during administration of plasma-expanders. An electrocardiogram registered after restoration of sinus rhythm showed mild ST-elevation in the anterior precordial leads and T waves changes followed by appearance of echocardiographic alterations of left ventricular apex kinesis. Coronary angiography revealed normal coronary arteries, and cardiovascular magnetic resonance confirmed apical ballooning with late gadolinium enhancement in the segments with abnormal contractility. This uncommon clinical case confirms how takotsubo and Kounis syndrome may converge in a single nosological entity, the so-called “ATAK complex” (Adrenaline, Tako-Tsubo, Anaphylaxis, and Kounis), with a specific management and prognostic implications. <Learning objective: The Kounis syndrome has a clinical presentation that poses a difficult differential diagnosis with takotsubo cardiomyopathy. Despite recent significant improvements in the understanding of these two clinical conditions, the pathogenesis of these two entities and, in particular, how they may converge into the clinical scenario of the “ATAK complex” remain to be clarified. We believe that this rare clinical case may help physicians in the correct identification and management of this frequently misdiagnosed clinical disease.>

Original languageEnglish
JournalJournal of Cardiology Cases
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Takotsubo Cardiomyopathy
Anaphylaxis
Kinesis
Gadolinium
Heart Arrest
Coronary Angiography
Epinephrine
Coronary Vessels
Electrocardiography
Magnetic Resonance Spectroscopy

Keywords

  • Anaphylaxis
  • ATAK complex
  • Cardiac arrest
  • Kounis syndrome
  • Takotsubo cardiomyopathy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Takotsubo cardiomyopathy associated with Kounis syndrome : A clinical case of the “ATAK complex”. / Margonato, Davide; Abete, Raffaele; Di Giovine, Gabriella; Delfino, Pietro; Grillo, Massimiliano; Mazzetti, Simone; Poggio, Daniele; Rossi, Jessica; Khouri, Toufic; Mortara, Andrea.

In: Journal of Cardiology Cases, 01.01.2019.

Research output: Contribution to journalArticle

Margonato, Davide ; Abete, Raffaele ; Di Giovine, Gabriella ; Delfino, Pietro ; Grillo, Massimiliano ; Mazzetti, Simone ; Poggio, Daniele ; Rossi, Jessica ; Khouri, Toufic ; Mortara, Andrea. / Takotsubo cardiomyopathy associated with Kounis syndrome : A clinical case of the “ATAK complex”. In: Journal of Cardiology Cases. 2019.
@article{2ab2759631be4079b0eb7a19f98a16ee,
title = "Takotsubo cardiomyopathy associated with Kounis syndrome: A clinical case of the “ATAK complex”",
abstract = "A 60-year-old female developed cardiac arrest after experiencing an anaphylactic shock during administration of plasma-expanders. An electrocardiogram registered after restoration of sinus rhythm showed mild ST-elevation in the anterior precordial leads and T waves changes followed by appearance of echocardiographic alterations of left ventricular apex kinesis. Coronary angiography revealed normal coronary arteries, and cardiovascular magnetic resonance confirmed apical ballooning with late gadolinium enhancement in the segments with abnormal contractility. This uncommon clinical case confirms how takotsubo and Kounis syndrome may converge in a single nosological entity, the so-called “ATAK complex” (Adrenaline, Tako-Tsubo, Anaphylaxis, and Kounis), with a specific management and prognostic implications. <Learning objective: The Kounis syndrome has a clinical presentation that poses a difficult differential diagnosis with takotsubo cardiomyopathy. Despite recent significant improvements in the understanding of these two clinical conditions, the pathogenesis of these two entities and, in particular, how they may converge into the clinical scenario of the “ATAK complex” remain to be clarified. We believe that this rare clinical case may help physicians in the correct identification and management of this frequently misdiagnosed clinical disease.>",
keywords = "Anaphylaxis, ATAK complex, Cardiac arrest, Kounis syndrome, Takotsubo cardiomyopathy",
author = "Davide Margonato and Raffaele Abete and {Di Giovine}, Gabriella and Pietro Delfino and Massimiliano Grillo and Simone Mazzetti and Daniele Poggio and Jessica Rossi and Toufic Khouri and Andrea Mortara",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jccase.2019.03.007",
language = "English",
journal = "Journal of Cardiology Cases",
issn = "1878-5409",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Takotsubo cardiomyopathy associated with Kounis syndrome

T2 - A clinical case of the “ATAK complex”

AU - Margonato, Davide

AU - Abete, Raffaele

AU - Di Giovine, Gabriella

AU - Delfino, Pietro

AU - Grillo, Massimiliano

AU - Mazzetti, Simone

AU - Poggio, Daniele

AU - Rossi, Jessica

AU - Khouri, Toufic

AU - Mortara, Andrea

PY - 2019/1/1

Y1 - 2019/1/1

N2 - A 60-year-old female developed cardiac arrest after experiencing an anaphylactic shock during administration of plasma-expanders. An electrocardiogram registered after restoration of sinus rhythm showed mild ST-elevation in the anterior precordial leads and T waves changes followed by appearance of echocardiographic alterations of left ventricular apex kinesis. Coronary angiography revealed normal coronary arteries, and cardiovascular magnetic resonance confirmed apical ballooning with late gadolinium enhancement in the segments with abnormal contractility. This uncommon clinical case confirms how takotsubo and Kounis syndrome may converge in a single nosological entity, the so-called “ATAK complex” (Adrenaline, Tako-Tsubo, Anaphylaxis, and Kounis), with a specific management and prognostic implications. <Learning objective: The Kounis syndrome has a clinical presentation that poses a difficult differential diagnosis with takotsubo cardiomyopathy. Despite recent significant improvements in the understanding of these two clinical conditions, the pathogenesis of these two entities and, in particular, how they may converge into the clinical scenario of the “ATAK complex” remain to be clarified. We believe that this rare clinical case may help physicians in the correct identification and management of this frequently misdiagnosed clinical disease.>

AB - A 60-year-old female developed cardiac arrest after experiencing an anaphylactic shock during administration of plasma-expanders. An electrocardiogram registered after restoration of sinus rhythm showed mild ST-elevation in the anterior precordial leads and T waves changes followed by appearance of echocardiographic alterations of left ventricular apex kinesis. Coronary angiography revealed normal coronary arteries, and cardiovascular magnetic resonance confirmed apical ballooning with late gadolinium enhancement in the segments with abnormal contractility. This uncommon clinical case confirms how takotsubo and Kounis syndrome may converge in a single nosological entity, the so-called “ATAK complex” (Adrenaline, Tako-Tsubo, Anaphylaxis, and Kounis), with a specific management and prognostic implications. <Learning objective: The Kounis syndrome has a clinical presentation that poses a difficult differential diagnosis with takotsubo cardiomyopathy. Despite recent significant improvements in the understanding of these two clinical conditions, the pathogenesis of these two entities and, in particular, how they may converge into the clinical scenario of the “ATAK complex” remain to be clarified. We believe that this rare clinical case may help physicians in the correct identification and management of this frequently misdiagnosed clinical disease.>

KW - Anaphylaxis

KW - ATAK complex

KW - Cardiac arrest

KW - Kounis syndrome

KW - Takotsubo cardiomyopathy

UR - http://www.scopus.com/inward/record.url?scp=85064866404&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064866404&partnerID=8YFLogxK

U2 - 10.1016/j.jccase.2019.03.007

DO - 10.1016/j.jccase.2019.03.007

M3 - Article

AN - SCOPUS:85064866404

JO - Journal of Cardiology Cases

JF - Journal of Cardiology Cases

SN - 1878-5409

ER -