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The Allergic Angina Syndrome in Naproxen Sodium Induced Type 1 Hypersensitivity Reaction in an Allergic Asthmatic Young Woman: Kounis Syndrome

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A twenty-year old female with a history of allergic asthma and Raynaud's phenomenon was admitted to our emergency department with retrosternal chest pain of one hour duration accompanied by generalized erythema, urticarial rashes, moderate dyspnea, nausea and vomiting. Her symptoms developed after taking a dose of naproxen sodium for dysmenorrhea. ECG showed ST segment elevation in leads I and aVL and ST segment depression in leads III and aVF. The patient's chest pain relieved and ST elevations resolved during her transport to the catheterization laboratory, Immediate angiography revealed normal coronary arteries.This coronary syndrome was thought to be secondary to allergy-induced coronary vasospasm known as ”Kounis syndrome”. The main pathophysiological mechanism of coronary spasm in Kounis syndrome is the inflammatory mediators released during a hypersensitivity reaction triggered by food, insect bites or drugs. Here, we report a case of coronary spasm secondary to allcrgic reaction following naproxen sodium intake.

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