Kounis syndrome after ingestion of undercooked fish: New role of intracoronary imaging techniques

Abstract

Kounis syndrome is a type of acute coronary syndrome that encompasses different forms of presentation as coronary vasospasm, acute myocardial infarction and stent thrombosis, all of them as results of allergic or anaphylactic reaction [1]. In this context, a variety of inflammatory mediators including histamine, proteases, arachidonic acid products and cytokines are released by mast cells and other inflammatory cells when the patient comes into contact with an allergen. The result is an insult to the cardiovascular system in any of the three forms previously mentioned as a consequence of the direct action of the inflammatory mediators: histamine, leukotrienes, thromboxane and platelet-activating factor (PAF), that can cause coronary vasoconstriction; proteases can induce erosion and rupture of coronary plaques, and tryptase and thromboxane have thrombotic properties [1].