Abstract

Kounis syndrome is a hypersensitivity acute coronary disorder which occurs with allergic reaction with drugs, food and insect bite. Atropine is rarely found to be reported with such allergic reactions in the literatures. In this report, we describe a case of a 25 years old male, with a background history of psychotic disorder and cannabis dependent syndrome with persistent bradycardia. When challenged with atropine he developed chest pain, shortness of breath and urticarial rash. ECG showed ST segment changes which settled after symptomatic management. Coronary angiogram revealed normal coronary arteries. Though uncommonly reported, it is one of the confusing and underdiagnosed serious conditions for treating physicians which can potentially mimic ST segment elevation myocardial infarction.

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