TITLE:
Refractory Ventricular Fibrillation with Underlying Coronary Artery Disease after COVID-19 Vaccine-Kounis Syndrome or Coincidence
AUTHORS:
Elaine M. C. Chau
KEYWORDS:
Refractory Ventricular Fibrillation, COVID-19 Vaccine, Kounis Syndrome
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.13 No.8,
August
26,
2024
ABSTRACT: A 63-year-old man with diabetes and asymptomatic coronary artery disease developed refractory ventricular arrhythmia at 20 hours at rest after his second COVID-19 vaccine. Despite significant stenosis in the coronary arteries, there was no evidence of acute or old myocardial infarction, heart failure, myocarditis or structural abnormalities on post-mortem to account for the substrate for the fatal arrhythmia. The refractory and incessant nature of the ventricular fibrillation and post-mortem finding of a grossly elevated unexplained IgE level (in the absence of acute myocardial infarction) suggested the possibility of Kounis Syndrome or allergic acute coronary syndrome.