Lots of interesting abstracts and cases were submitted for TCTAP 2026. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge!

CASE20251104_015

Ondansetron-Induced Coronary Artery Vasospasm: Kounis Syndrome

By Kochamarj Boonyarattaphun, Poranee Laoitthi

Presenter

Poranee Laoitthi

Authors

Kochamarj Boonyarattaphun¹, Poranee Laoitthi²

Affiliation

Somdech Phra Pinklao Hospital, Thailand¹, Chulalongkorn University, Thailand²

View Study Report

CASE20251104_015

Coronary - ACS/AMI

Ondansetron-Induced Coronary Artery Vasospasm: Kounis Syndrome

Kochamarj Boonyarattaphun¹, Poranee Laoitthi²

Somdech Phra Pinklao Hospital, Thailand¹, Chulalongkorn University, Thailand²

Clinical Information

Relevant Clinical History and Physical Exam

A 49-year-old male, with past history of diabetes mellitus, hypertension and dyslipidemia, presented to emergency room (ER) with dizziness and nausea. He had come to ER two weeks prior to this event with dysarthria and hemiparesis, then recovery within 24 hours. The diagnosis was transient ischemic attack. Initial treatments were IV dimenhydrinate 50 mg and ondansetron 8 mg. Patient developed chest pain as"gunshot wound in mid chest area" after 5 minutes and felt severe heart palpitation

Relevant Test Results Prior to Catheterization

ECG showed non-specific ST-T depression at V5-6 (picture 1). It had changed from previous ECG (picture 2). Patient was managed as Non-ST-Elevation Myocardial Infarction (NSTEMI) with dual antiplatelet therapy and low molecular weight heparin (LMWH). High sensitivity Trop T was raising from 7 ng/L to 649 ng/L within 3 hours. Echocardiogram showed good LV systolic function, ejection fraction 67.3% without regional wall movement abnormality.

Relevant Catheterization Findings

Patient was transferred to cardiac catheterization laboratory room. After coronary angiogram was performed, it showed normal coronary arteries both right and left coronary system (picture 3).

Interventional Management

Procedural Step

Coronary angigram was performed. A procedure using X-rays and a special dye to check for blockages in the coronary arteries that supply blood to the heart. A thin tube called a catherter is inserted into an artery in the groin or wrist, guided to the heart, and a contrast dye is injected to make the arteries visible on X-rays. The procedure typically takes 30 to 60 minutes and requires only local anesthetic. it showed normal coronary arteried both right and left coronary system. After procedure, patient was observed sign and symptoms of complication

Case Summary

Kounis syndrome induced by Ondansetron was rarely reported in academic journal. Therefore, patient presented with ischemic myocardial injury due to anaphylactoid reaction induced by Ondansetron would be interesting to explore.

E-Case

CASE20251104_015