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  • Title: [Acute coronary syndrome after insect bites: a systematic review of available literature].
    Author: Monello A, Moderato L, Lazzeroni D, Benatti G, Demola P, Binno S, Vermi AC, Valenti G, Losi L, Rusticali G, Piepoli MF.
    Journal: G Ital Cardiol (Rome); 2021 Nov; 22(11):944-949. PubMed ID: 34709235.
    Abstract:
    BACKGROUND: Kounis syndrome is a hypersensitivity coronary disorder induced by exposure to several triggers; the most common are antibiotics, followed by insect bites. METHODS: We reviewed the literature and identified 66 patients who experienced acute coronary syndrome after insect bites. RESULTS: The median age was 51 years, and 19.0% were women and only 12% had a history of allergy. The most involved insects were bee and wasp (86%) and the most frequent clinical manifestations were chest pain and anaphylaxis (36% and 29%, respectively). ST-segment elevation was the most common electrocardiographic finding (>70%). There was a not negligible rate of complications (15%), with a possible increased arrhythmic burden in patients without significant coronary atherosclerosis. CONCLUSIONS: Acute coronary syndrome after insect bites is not so rare and it could have serious complications, with a possible increased arrhythmic burden in patients without significant coronary atherosclerosis.
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