Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Mar 9;35(3):369-370.
doi: 10.1080/08998280.2022.2034226. eCollection 2022.

Kounis syndrome following COVID-19 vaccination

Chadi Allam  1   2 , Nicholas G Kounis  3 , Roy Chlawit  1   2 , Marc Saouma  1   2 , Georges Badaoui  1   2
Affiliations
Case Reports

Kounis syndrome following COVID-19 vaccination

Chadi Allam et al. Proc (Bayl Univ Med Cent). .

Abstract

Coronary stent thrombosis is a life-threatening condition induced by multiple factors, including allergic reactions. A 64-year-old man presented with stent thrombosis in the left anterior descending artery and multiple cardiorespiratory arrests immediately after the first dose of the BNT162b1 mRNA vaccine. He underwent emergent percutaneous coronary intervention. Anaphylaxis-induced stent thrombosis, or type III Kounis syndrome, is a highly possible diagnosis. Cardiogenic shock can hide the skin manifestations of anaphylaxis, making this syndrome challenging to diagnose. This clinical case underscores the importance of surveillance for at least 30 minutes after vaccine administration, especially in patients at risk.

Keywords: Anaphylaxis; COVID-19; Kounis syndrome; myocardial infarction; stent thrombosis; vaccine.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Electrocardiogram on presentation showing ST segment elevation in the anteroseptal leads.
Figure 2.
Figure 2.
(a) Coronary angiogram demonstrating a stent thrombosis of the left anterior descending artery (asterisk) (see also Supplemental Video 1). (b) Coronary angiogram following aspiration thrombectomy and balloon angioplasty along with intracoronary tirofiban injection in the left anterior descending artery (asterisk) with persistent thrombi (arrow) (see also Supplemental Video 2).
See this image and copyright information in PMC

References

    1. Allam C, Saouma M, Chlawit R.. Kounis syndrome must be considered in the differential diagnosis of myocardial infarction following COVID-19 vaccination. QJM. 2022. doi:10.1093/qjmed/hcac001. - DOI - PMC - PubMed
    1. Giovannini M, Koniari I, Mori F, Barni S, Novembre E, Kounis NG.. Kounis syndrome: towards a new classification. Int J Cardiol. 2021;341:13–14. doi:10.1016/j.ijcard.2021.04.018. - DOI - PubMed
    1. Kounis NG, Koniari I, de Gregorio C, et al. . Allergic reactions to current available COVID-19 vaccinations: pathophysiology, causality, and therapeutic considerations. Vaccines (Basel). 2021;9(3):221. doi:10.3390/vaccines9030221. - DOI - PMC - PubMed
    1. Kounis NG, Cervellin G, Koniari I, et al. . Anaphylactic cardiovascular collapse and Kounis syndrome: systemic vasodilation or coronary vasoconstriction? Ann Transl Med. 2018;6(17):332. doi:10.21037/atm.2018.09.05. - DOI - PMC - PubMed
    1. Tajstra M, Jaroszewicz J, Gąsior M.. Acute coronary tree thrombosis after vaccination for COVID-19. JACC Cardiovasc Interv. 2021;14(9):e103–e104. doi:10.1016/j.jcin.2021.03.003. - DOI - PMC - PubMed

Publication types

LinkOut - more resources