Type 1 Kounis syndrome in a patient with idiopathic anaphylaxis

Abstract

Anaphylactic insults that cause cardiovascular signs and symptoms have been defined as Kounis syndrome, which has been associated with specific triggered anaphylactic reactions. Kounis syndrome has not been described in patients with no evidence of coronary artery disease (type I Kounis) in a scenario of idiopathic anaphylaxis. We reported a case of a 65-year-old white woman with no evidence of coronary artery disease who experienced two myocardial infarctions on separate occasions attributable to idiopathic anaphylaxis.

Figure 1.

Image of our patient's computed tomography angiogram of the heart demonstrated no evidence of coronary artery disease, which makes this case consistent with the type I variant of Kounis syndrome. RCA = Right coronary artery; Cx = circumflex artery; LAD = left anterior descending artery.