Abstract
Kounis syndrome is a well-known cause of acute coronary syndrome and more than 100 cases are reported with allergic reactions to various drugs, animal and insect bites, even with drug eluting stents and endovascular devices. In this paper we report five-patients with Kounis syndrome related to different drugs. The main characteristic of patients is given in Table 1. All of them were male and their age was from 18 to 35. All patients presented with ST- elevation myocardial infarction. Coronary angiography was performed in all patients and revealed normal coronary arteries. From history of allergic exposure, electrocardiographic, laboratory (Total IgE and tryptase levels) and angiographic findings the diagnosis was Kounis syndrome type I for all patients and was treated with oral antihistamines and prednisolone. Despite Type 1 KS is not associated with atherosclerotic risk factors and CAD all patients in or report and many patients in literature are male. Gender differences in KS should be investigated in further studies.
Highlights
The first paper in the literature, examining the acute myocardial infarction (MI) related to prolonged allergic reaction was published in 1950 [1]
The definition of Kounis syndrome was in 1991 as ‘‘the coincidental occurrence of chest pain and allergic reactions accompanied by clinical and laboratory findings of classic angina pectoris caused by inflammatory mediators released during the allergic insult’’ [2]
Case Descriptions In this paper we report five-patients with Kounis syndrome related to different drugs
Summary
The first paper in the literature, examining the acute myocardial infarction (MI) related to prolonged allergic reaction was published in 1950 [1]. The definition of Kounis syndrome (allergic angina) was in 1991 as ‘‘the coincidental occurrence of chest pain and allergic reactions accompanied by clinical and laboratory findings of classic angina pectoris caused by inflammatory mediators released during the allergic insult’’ [2]. Kounis syndrome is a wellknown cause of acute coronary syndrome and more than 100 cases are reported with allergic reactions to various drugs (antibiotics, analgesics, antineoplastics, contrast media, intravenous anaesthetics, no steroidal anti-inflammatory drugs, anticoagulants, proton pump inhibitors), animal and insect bites, even with drug eluting stents and endovascular devices [4, 5]. From history of allergic exposure, electrocardiographic, laboratory (Total IgE and tryptase levels) and angiographic findings the diagnosis was Kounis syndrome type I for all patients and was treated with oral antihistamines and prednisolone. All symptoms electrocardiographic and echocardiographic findings were resolved by the time of discharge
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