• A&A practice · Mar 2023

    Case Reports

    Intraoperative Kounis Syndrome and Fixation Errors: A Case Report.

    • Trent A Ogaz and BobbieJean Sweitzer.
    • From the University of Virginia School of Medicine, Charlottesville, Virginia.
    • A A Pract. 2023 Mar 1; 17 (3): e01672e01672.

    AbstractPostinduction hypotension, though frequently due to anesthetic medications, has a variety of causes. We present a case of presumed intraoperative Kounis syndrome, or anaphylaxis-induced coronary vasospasm, in which the patient's perioperative course was initially attributed to anesthesia-induced hypotension and iatrogenic rebound hypertension leading to Takotsubo cardiomyopathy. A second anesthetic event with immediate recurrence of hypotension after the patient received levetiracetam appears to confirm the diagnosis of Kounis syndrome. In this report, we discuss the fixation error that led to this patient's original misdiagnosis.Copyright © 2023 International Anesthesia Research Society.

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