A 71-year-old male patient reported to our hospital with anaphylactic shock, and the following two issues were focused in this case. First, he was resistant to adrenaline because of taking beta-blocker, and shock was repeated until glucagon administration was initiated. Second, he developed acute coronary syndrome. Two mechanisms contributing to Kounis syndrome were differentiated: 1) adrenaline induced coronary spasm and platelet activation or 2) a mismatch between oxygen supply and demand due to an allergic reaction. Beta-blocker therapy was discontinued because his cardiac function was preserved. Secondary preventive beta-blockers in recovering myocardial infarction with severe anaphylaxis history should be carefully considered.

中文翻译：

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对于 Kounis 综合征，是否应该继续使用 β 受体阻滞剂治疗心肌梗死？

一名71岁男性患者向我院报告过敏性休克，该病例主要关注以下两个问题。首先，由于服用β受体阻滞剂，他对肾上腺素产生抵抗力，并且反复休克，直到开始给予胰高血糖素。其次，他患上了急性冠状动脉综合症。导致 Kounis 综合征的两种机制有所不同：1）肾上腺素诱导冠状动脉痉挛和血小板活化，或 2）由于过敏反应导致氧气供需不匹配。由于他的心脏功能得以保留，β-受体阻滞剂治疗被终止。对于有严重过敏反应史的心肌梗死恢复期，应仔细考虑使用二级预防性β受体阻滞剂。