A Chest Pain Patient Quadruples Possible Cardiac Syndromes-Acute Coronary Syndrome, Takotsubo Syndrome, Cardiac Anxiety Syndrome and Kounis Syndrome: A Challenging Case Report and Review of the Differentiation

Xu T1*, Li X1, Huang Q1, Fu Y2, Weng J1 and Chen Y1*

1Department of Cardiology, Peking University of Shenzhen Hospital, China
2Department of Radiology, Peking University of Shenzhen Hospital, China

^*Correspondance to: Tan Xu 

 PDF  Full Text Case Report | Open Access

Abstract:

This case report illustrates the clinical course and differentiation of severe cardiac syndromes in a female patient in her 50s presenting with acute chest pain, meanwhile in allergic state and stress condition. The patient was totally relieved from chest pain by oral anti-histamine and further stay was uneventful. The first impression was cardiac anxiety syndrome. As the troponin elevated with typical ECG changes, coronary angiography and left ventriculography was performed. The negative findings indicated the diagnosis as MINOCA, possible Kounis syndrome. The cardiac MR imaging of the patient classified the final diagnosis as TTS. Cardiologists should be aware of the possible cardiac syndromes in one patient, which may have important clinical implications particularly in the presence of concomitant non-atherosclerotic disease, allergic state and stress condition. This discreet differentiation helps to avoid unnecessary therapy or even coronary intervention.

Keywords:

Chest pain; Acute coronary syndrome; Takotsubo syndrome; Cardiac anxiety syndrome; Kounis syndrome

Cite the Article:

Xu T, Li X, Huang Q, Fu Y, Weng J, Chen Y. A Chest Pain Patient Quadruples Possible Cardiac Syndromes-Acute Coronary Syndrome, Takotsubo Syndrome, Cardiac Anxiety Syndrome and Kounis Syndrome: A Challenging Case Report and Review of the Differentiation. Ann Clin Case Rep. 2024; 9: 2609.