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  2. Keyword: Tramadol
IJCS
Case Report

Kounis Syndrome: Case Report in Goiânia/BR

Marília Pereira et al. Gabriela Lima Vieitas Anna Ilona Hunkar Freitas Karoly Gyula Olivas Hunkar

Abstract

22-year-old male patient with no heart disease, who was given an ambulatory medication with analgesics due to an acute renal crisis. After the drug administration, the patient presented dyspnea, cyanosis, and hemoptysis. There was suspicion of anaphylactic shock, which was treated, but there was no improvement in the clinical condition. The patient was referred to the Intensive Care Unit, where tests were performed showing elevated cardiac enzymes and Immunoglobulin E and Computed Tomography of Thoracic revealed alveolar hemorrhage. He developed clinical worsening and died after sepsis. The final diagnosis was of kounis syndrome due to the hypersensitivity reaction to the analgesics introduced in the patient, generating an acute coronary syndrome (ACS). The purpose of this case report was to highlight a syndrome that is little reported because it is not part of the differential diagnosis routines of ACS, but it generates important complications.

  • Acute coronary syndrome
  • Biomarkers
  • Diagnostic Imaging
  • Heart/drug effects
  • Hemorrhage
  • Immunoglobulins
  • Kounis Syndrome
  • Sepsis
  • Tramadol
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Creative Commons Attribution (CC BY) Creative Commons license
17/06/2021 DOI: 10.36660/ijcs.20200019 Views 1
Inhibition of L-type calcium current by tramadol and enantiomers in cardiac myocytes from rats
ABC
Artigo Original

Inhibition of L-type calcium current by tramadol and enantiomers in cardiac myocytes from rats

Emiliano Medei et al. Juliana M. Raimundo José Hamilton M. Nascimento Margarete M. Trachez … Roberto T. Sudo Gisele Zapata-Sudo

BACKGROUND: Tramadol is a centrally acting analgesic, whose mechanism of action involves opioid-receptor activation. Previously, we have shown that tramadol and its enantiomers had a negative inotropic effect on the papillary muscle in which the (+)-enantiomer is more potent than (-)- and (±)-tramadol. OBJECTIVE: In this study, we investigated the effects of tramadol and its enantiomers on L-type calcium current (I Ca-L). RESULTS: Tramadol (200 µM) reduced the peak amplitude of I Ca-L at potentials from 0 to +50 mV. At 0 mV, I Ca-L was reduced by 33.7 ± 7.2%. (+)- and (-)-tramadol (200 µM) produced a similar inhibition of I Ca-L, in which the peak amplitude was reduced by 64.4 ± 2.8% and 68.9 ± 5.8%, respectively at 0 mV (p > 0.05). Tramadol, (+)- and (-)-tramadol shifted the steady-state inactivation of I Ca-L to more negative membrane potentials. Also, tramadol and (+)-tramadol markedly shifted the time-dependent recovery curve of I Ca-L to the right and slowed down the recovery of I Ca-L from inactivation. The time constant was increased from 175.6 ± 18.6 to 305.0 ± 32.9 ms (p < 0.01) for tramadol and from 248.1 ± 28.1 ms to 359.0 ± 23.8 ms (p < 0.05) for (+)-tramadol. The agonist of µ-opioid receptor DAMGO had no effect on the I Ca-L. CONCLUSION: The inhibition of I Ca-L induced by tramadol and its enantiomers was unrelated to the activation of opioid receptors and could explain, at least in part, their negative cardiac inotropic effect.

  • calcium channels, L-type
  • Myocytes, Cardiac
  • Rats
  • Tramadol
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Creative Commons Attribution (CC BY) Creative Commons license
30/09/2011 DOI: 10.1590/S0066-782X2011005000091 Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Pereira M, Vieitas GL, Freitas AIH, Hunkar KGO. Kounis Syndrome: Case Report in Goiânia/BR. International Journal of Cardiovascular Sciences 2021;34(5 Supl 1):135-8.

Electronic Document Format (ABNT)

Pereira, Marília; Vieitas, Gabriela Lima; Freitas, Anna Ilona Hunkar; Hunkar, Karoly Gyula Olivas. Kounis Syndrome: Case Report in Goiânia/BR. International Journal of Cardiovascular Sciences, v. 34, n. 5 Supl 1, p. 135-138, Jun. 2021.

Electronic Document Format (APA)

Pereira, M., Vieitas, G. L., Freitas, A. I. H., & Hunkar, K. G. O. (2021). Kounis Syndrome: Case Report in Goiânia/BR. International Journal of Cardiovascular Sciences, 34(5 Supl 1), 135-138.

Electronic Document Format (ISO)

Pereira, Marília and Vieitas, Gabriela Lima and Freitas, Anna Ilona Hunkar and Hunkar, Karoly Gyula Olivas. Kounis Syndrome: Case Report in Goiânia/BR. International Journal of Cardiovascular Sciences [online]. 2021, vol. 34, n. 5 Supl 1, [cited 2026-10-14], pp. 135-138. Available from: <https://journals.cardiol.br/en/article/kounis-syndrome-case-report-in-goiania-br/>. ISSN 2359-4802

EndNote RIS

Electronic Document Format (Vancouver)

Medei E, Raimundo JM, Nascimento JHM, Trachez MM, Sudo RT, Zapata-Sudo G. Inhibition of L-type calcium current by tramadol and enantiomers in cardiac myocytes from rats. Arquivos Brasileiros de Cardiologia 2011;97(4):324-31.

Electronic Document Format (ABNT)

Medei, Emiliano; Raimundo, Juliana M.; Nascimento, José Hamilton M.; Trachez, Margarete M.; Sudo, Roberto T.; Zapata-Sudo, Gisele. Inhibition of L-type calcium current by tramadol and enantiomers in cardiac myocytes from rats. Arquivos Brasileiros de Cardiologia, v. 97, n. 4, p. 324-331, Sep. 2011.

Electronic Document Format (APA)

Medei, E., Raimundo, J. M., Nascimento, J. H. M., Trachez, M. M., Sudo, R. T., & Zapata-Sudo, G. (2011). Inhibition of L-type calcium current by tramadol and enantiomers in cardiac myocytes from rats. Arquivos Brasileiros de Cardiologia, 97(4), 324-331.

Electronic Document Format (ISO)

Medei, Emiliano and Raimundo, Juliana M. and Nascimento, José Hamilton M. and Trachez, Margarete M. and Sudo, Roberto T. and Zapata-Sudo, Gisele. Inhibition of L-type calcium current by tramadol and enantiomers in cardiac myocytes from rats. Arquivos Brasileiros de Cardiologia [online]. 2011, vol. 97, n. 4, [cited 2026-10-14], pp. 324-331. Available from: <https://journals.cardiol.br/en/article/inhibition-of-l-type-calcium-current-by-tramadol-and-enantiomers-in-cardiac-myocytes-from-rats/>. ISSN 0066-782X

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