Acute coronary syndrome in cisatracurium-induced anaphylactic shock: Kounis syndrome

Ya Ling Yang, Hui Wen Huang, Hon Kan Yip, Bruno Jawan, Chia Chih Tseng, Hsiao Feng Lu

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


In this case report, we describe a 70-year-old male patient who sustained Kounis syndrome induced by cisatracurium administration immediately following induction of general anesthesia. Acute coronary syndrome combined with anaphylactic shock, termed Kounis syndrome, should be investigated in percutaneous coronary intervention to solve this complex and life-threatening condition. A team effort by cardiologist and anesthesiologist is essential for successful resuscitation. In general, the incidence of an anaphylactic reaction to cisatracurium is low, but a high serum IgE level in combination with a positive skin prick test in our patient was strongly suggestive of cisatracurium-induced Kounis syndrome. In addition, a cross-reaction between cisatracurium and rocuronium is reported.

Original languageEnglish
Pages (from-to)184-186
Number of pages3
JournalActa Anaesthesiologica Taiwanica
Issue number4
Publication statusPublished - 2008 Dec

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine


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