A Tucson man died this week from cardiac causes after being swarmed by bees. He and a fellow landscaper, as well as a resident of the home were attacked by bees, turning deadly when he fell unconscious and went into cardiac arrest.
Bee stings can commonly cause allergic reactions, some so severe that anaphylaxis ensues, causing respiratory difficulty as the linings of the lungs constrict during the severe allergy attack. However uncommonly, bee stings could affect the heart. And not just instantly.
In 2016 a man from India died of cardiac arrest 3 weeks after being stung by 50 bees. Even though all the stingers were removed, he suffered from Kounis syndrome, an exaggerated histamine release that affects blood vessels such that they constrict abnormally. Its believed that the coronary artery vasospasm caused his heart to stop.
Heart attacks occur when the heart muscle fails to receive the oxygenated blood it needs due to vessel blockage. Cardiac arrest occurs when the heart stops beating due to a heart attack or electrical abnormality that prevents the heart muscle from working.
What is Kounis Syndrome?
Kounis Syndrome was first described in 1991 by researchers Kounis and Zavras as an acute coronary syndrome caused by an allergic or hypersensitivity reaction.
Mast cells release inflammatory mediators, such as histamine, when exposed to an allergen, or foreign body, in hopes of coughing and sneezing out, or walling off the antigen. In Kounis syndrome, these mediators can cause a variety of cardiac effects including vasospasm of the coronary arteries supplying the heart, heart attack, clot formation in stents that were placed to keep coronary arteries open, and damage to heart muscle that could prevent the electrical conductivity needed to keep the organ beating.
Many environmental factors could trigger Kounis syndrome, including insect stings. And weeks may pass before the cardiac effects become fatal. It’s been suggested that some heart attacks might have been preceded by an allergy that caused Kounis syndrome but was never determined or investigated since the patient never thought to relate to two events.
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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician