Allergic reactions may cause acute coronary syndrome by coronary spasm, acute stent thrombosis or coronary plaque rupture via releasing of inflammatory cytokines. This clinical entity is termed as Kounis Syndrome. We encountered a 64-year-old male who admitted to emergency department of our hospital with complaints of chest pain, shortness of breath, nausea and vomiting. Before the application, it was found that he used diclofenac orally for headache. His electrocardiography(ECG) showed ST-segment elevations in lateral derivations. Emergency coronary angiography revealed normal coronary vessels. He was eventually diagnosed with an anaphylactic reaction. After successful treatment of anaphylaxis, ST-segment elevations resolved. C linicians should be aware of this syndrome for promt recognition and proper treatment. Özet: A llerjik reaksiyonlar, koroner spazm, akut stent trombozu veya inflamatuar sitokinlerin salınması sonucu koroner plak rüptürü yoluyla akut koroner sendroma neden olabilirler. Bu klinik antite Kounis Sendromu olarak adlandırılır. 6 4 yaşında erkek hasta göğüs ağrısı, nefes darlığı, bulantı ve kusma şikayetleri ile hastanemiz acil servisine başvurdu. Başvuru öncesinde baş ağrısı için oral yolla diklofenak kullandığı tespit edildi. Elektrokardiyografisinde(EKG) lateral derivasyonlarda ST-segment yükselmesi izlendi. Acil koroner anjiyografide koroner damarlar normaldi. Hastaya anafilaktik reaksiyon teşhisi kondu. Anafilaksi başarıyla tedavi edildikten sonra, ST-segment yükselmeleri çözüldü. Klinisyenler bu sendromun hızlı tanı ve uygun tedavi için farkında olmalıdır.

A limited number of studies have investigated QT wave dispersion (QTd) in depressive disorder. The objective of this study was to investigate whether QTd differed in patients diagnosed with depression compared to a control group and whether the difference correlated with the depression and anxiety scores. Forty patients diagnosed with major depressive disorder (DSM-5 criteria) who did not receive their first treatment after the first episode were included in the study. Forty healthy individuals with similar sociodemographic characteristics were included in the control group. A sociodemographic and clinical data form, the Beck Depression Inventory, and the Beck Anxiety Inventory were given to all patients. Electrocardiograms were evaluated in a single-blind setting by the same cardiologist. The longest QT interval (QTmax) and the shortest QT interval (QTmin) were calculated. Heart rate-corrected QTmax (QTcmax) and QTmin (QTcmin) were calculated using the Bazett formula (QT[ms]/√R-R). The difference between QTcmax and QTcmin was accepted as the corrected QT dispersion (QTcd). The study was conducted from December 2018-March 2019. No statistically significant difference was found between patient and control groups on the basis of age, sex, body mass index, or smoking. Beck Anxiety Inventory and Beck Depression Inventory scores of the patient group (28.48 ± 12.39 and 32.2 ± 11.58, respectively) were significantly higher compared to the control group (2.7 ± 3.41 and 2.75 ± 3.2, respectively). The patient group QTcmax (419.8 ± 24.46) and QTcd (42.55 ± 17.47) values were significantly higher compared to the QTcmax (405.2 ± 24.54) and QTcd (30.48 ± 9.25) values of the control group. There was a positive correlation between QTcd, QTcmax, and anxiety and depression scores. QTcd values of depressed patients were higher than those of the healthy controls, and there was a positive correlation between QTcd and depression and anxiety scores.

We read with interest the study by Li et al