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Case Reports
. 2017 May 23;11(1):145.
doi: 10.1186/s13256-017-1310-7.

Management of Kounis syndrome: two case reports

Majdi Omri  1   2 , Hajer Kraiem  3   4 , Olfa Mejri  1   5 , Mounir Naija  2 , Naoufel Chebili  1   2
Affiliations
Case Reports

Management of Kounis syndrome: two case reports

Majdi Omri et al. J Med Case Rep. .

Abstract

Background: Kounis syndrome corresponds to the occurrence of myocardial injury following an allergic insult. This syndrome is infrequent, and is not well known. In consequence, it is usually misdiagnosed leading to inappropriate treatment. The current literature is limited to case studies and there are no international recommendations concerning this topic.

Case presentation: We discussed, through two case reports, the clinical presentation and the management of a 60-year-old North African man and a 45-year-old North African man presenting with chest pain suggesting acute coronary syndrome following anaphylactic reaction. Triggering factors were a drug in the first case and herbal dermal exposure in the second. A clinical examination and electrocardiogram revealed anaphylactic reaction associated with myocardial infarction. Appropriate management of these two life-threatening conditions allowed an improvement in our patients' condition and their transfer to specialized units.

Conclusions: Although Kounis syndrome is a rare phenomenon, physicians should be aware of its physiopathological mechanisms in order to treat it appropriately. The difficulty lies in the fact that the treatment of either of the two associated entities may worsen the other injury.

Keywords: Acute coronary syndrome; Anaphylaxis; Case report; Kounis syndrome; Management.

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Figures

Fig. 1
Fig. 1
a Patient’s initial electrocardiogram showing ST elevation in the inferior wall with reciprocal change in anterolateral leads. b Patient’s electrocardiogram after fibrinolysis showing regression of ST elevation in inferior wall
Fig. 2
Fig. 2
Electrocardiogram showing ST elevation in anterior leads with ST depression in inferior wall
Fig. 3
Fig. 3
Coronarography showing total mid-left anterior descending artery occlusion (Thrombolysis in Myocardial Infarction Grade Flow 0)
Fig. 4
Fig. 4
Partial opening of left anterior descending artery after balloon inflation at the occlusion site (Thrombolysis in Myocardial Infarction Grade Flow I)
Fig. 5
Fig. 5
Reopening of left anterior descending artery after thrombo-aspiration and stenting (Thrombolysis in Myocardial Infarction Grade Flow III)
See this image and copyright information in PMC

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