{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:11:42Z","timestamp":1789002702953,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Adrenaline, stress cardiomyopathy, allergic reactions, and Kounis syndrome (Adrenaline, Takotsubo, Anaphylaxis, Kounis Complex, ATAK) constitute a complex clinical syndrome often associated with endogenous or exogenous adrenaline. Due to its rapid onset, severity, and treatment challenges, it warrants significant attention from clinicians. This article reports a case of Type II Kounis syndrome combined with stress cardiomyopathy (ATAK) triggered by a latamoxef-induced allergy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>A 67-year-old male patient with an acute exacerbation of chronic obstructive pulmonary disease was admitted to the respiratory department for treatment. The day before discharge, after receiving a latamoxef infusion for 27\u2005min, the patient developed wheezing, dyspnea, chills, profuse sweating, and an elevated body temperature, necessitating transfer to the ICU for monitoring and treatment. The ECG suggested a suspected myocardial infarction, while bedside echocardiography showed a left ventricular ejection fraction of 40%, segmental dysfunction of the left ventricle, and apical rounding. Emergency coronary angiography revealed 50% segmental eccentric stenosis in the mid-segment of the left anterior descending branch and right coronary artery. The final diagnosis was Type II Kounis Syndrome combined with stress cardiomyopathy due to a latamoxef-induced allergy, i.e., ATAK. Despite aggressive treatment, the patient succumbed to severe cardiogenic shock on the third day in the ICU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ATAK is a critical condition that progresses rapidly. For patients experiencing severe allergic reactions, monitoring biomarkers such as Troponin and ECG changes is crucial for timely recognition. If a patient is diagnosed with Kounis syndrome, caution should be exercised in using adrenaline to prevent ATAK.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2024.1383903","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T04:31:56Z","timestamp":1721622716000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["ATAK complex (adrenaline, takotsubo, anaphylaxis, and kounis hypersensitivity-associated coronary syndrome) related to latamoxef administration\u2014a case report"],"prefix":"10.3389","volume":"11","author":[{"given":"Sheng","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunlan","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiyang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"212","DOI":"10.4274\/balkanmedj.galenos.2019.2019.5.62","article-title":"Kounis syndrome\u2014not a single-organ arterial disorder but a multisystem and multidisciplinary disease","volume":"36","author":"Kounis","year":"2019","journal-title":"Balkan Med J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1186\/s13256-017-1310-7","article-title":"Management of Kounis syndrome: two case reports","volume":"11","author":"Omri","year":"2017","journal-title":"J Med Case Rep"},{"key":"B3","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1001\/jamainternmed.2018.6155","article-title":"A diagnostically challenging infusion reaction-kounis, takotsubo, or the ATAK!","volume":"179","author":"Mustehsan","year":"2019","journal-title":"JAMA Intern Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"62","DOI":"10.18176\/jiaci.0921","article-title":"ATAK complex due to amoxicillin: a case report","volume":"34","author":"Alarc\u00f3n Gallardo","year":"2024","journal-title":"J Investig Allergol Clin Immunol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1714\/2898.29219","article-title":"Adrenalina endovenosa in corso di reazione anafilattica: sindrome di Kounis o takotsubo? 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