Emergency medicine journal : EMJ
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Case Reports
Cardiac arrest secondary to type 2 Kounis syndrome resulting from urticaria and angioedema.
A 43-year-old man with no cardiac history presented with chest pain followed by cardiac arrest. He was successfully defibrillated and underwent primary percutaneous coronary angioplasty to a culprit coronary artery lesion. ⋯ Given the absence of cardiac symptoms before the development of the rash, it was hypothesised that coronary artery spasm precipitated by histamine release due to his dermatological condition contributed to his myocardial infarction and cardiac arrest. The final diagnosis was therefore cardiac arrest secondary to type II Kounis syndrome, resulting from idiopathic autoimmune or post-viral urticaria and angioedema.
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Little is known about how and when homeless people use the emergency department. It might be anticipated that attendances would increase in cold weather as homeless people seek possible shelter. The authors aimed to describe emergency department attendances by homeless people and determine whether ambient temperatures affect attendance rates. ⋯ We found no evidence to suggest that homeless people are more likely to attend the emergency department in cold weather. If anything, there was a small positive correlation between rate of attendances and daily temperature.