Intraoperative anaphylaxis, cardiac arrest and hypertrophic cardiomyopathy: Implications for Kounis syndrome

Anaphylactic reactions occurring during general anesthesia constitute the most severe and frequent forms of drug-induced hypersensitivity reactions. Although bronchospasm, cutaneous and mucus signs and symptoms are easily recognized, signs and symptoms that mainly involve the cardiovascular system constitute diagnostic and therapeutic problems. In the very interesting report published recently [1], a 75-year-old woman, hypertensive, smoker and allergic to penicillin and cephalosporin with vancomycin spacer placement, developed twice hypotensive cardiac arrest with pulseless electrical activity during preoperative general anesthesia for left total hip re-implantation.

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