Allergic angina can be determined by the early use of cardiac magnetic resonance imaging

Emet M., Kantarci M., Aksakal E., Cankaya B., Uzkeser M., Aslan Ş. , ...More

AMERICAN JOURNAL OF EMERGENCY MEDICINE, vol.28, no.9, 2010 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 28 Issue: 9
  • Publication Date: 2010
  • Doi Number: 10.1016/j.ajem.2010.01.029


Kounis syndrome (KS) is the simultane appearance of acute coronary syndrome with circumstances accompanied with mast cell degranulation and is precipitated via inflammatory mediators released through the mast cell activation. Generally, in published cases with KS, ST elevations on electrocardiogram (ECG) and marked cardiac enzyme elevations including troponins were observed. Here, we introduce a case who represented with symptoms of allergic angina without any finding on ECG and troponin elevation. Cardiac magnetic resonance imaging, on the second day, showed tapering of myocardium, hypokinesis in cardiac apex and apicoposterior septum, and minimal pericardial effusion adjacent to apex. We suggest that cardiac damage can happen in patients without any ECG and cardiac enzyme abnormality in KS. For chosen patients without any history of acute coronary syndrome, ECG change, and troponin elevation, we offer early use of cardiac magnetic resonance imaging, which is noninvasive and needs hypoallergic gadolinium for contrast imaging to show cardiac damage indirectly.