Kounis syndrome is a medical condition characterized by the onset of acute coronary syndrome (ACS) in association with an allergic or hypersensitivity reaction. It typically occurs when a person with pre-existing coronary artery disease experiences an allergic or hypersensitivity reaction, which triggers the release of inflammatory mediators such as histamine, leukotrienes, and cytokines. This leads to spasm of the coronary arteries, causing reduced blood flow to the heart and potentially angina or even myocardial infarction (heart attack).
Key points:
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Triggers: Medications (such as antibiotics, non-steroidal anti-inflammatory drugs, and contrast agents), insect stings, foods, environmental allergens, and latex.
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Symptoms: Chest pain, shortness of breath, palpitations, dizziness, and sweating.
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Diagnosis: Health intake plus electrocardiogram (ECG), cardiac biomarker testing (such as troponin), and coronary angiography to evaluate coronary artery anatomy and function.
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Treatment: Focus on managing the underlying allergic reaction, relieving symptoms of myocardial ischemia, and preventing complications such as myocardial infarction. This may include administration of antihistamines, corticosteroids, bronchodilators, nitroglycerin, and other medications as appropriate. In severe cases, interventions such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) may be necessary to restore blood flow to the heart.
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Prevention: Avoid known triggers of allergic reactions. Carry appropriate medications (such as adrenaline autoinjectors and nitroglycerin). Wear medical alert identification to alert healthcare providers in the event an emergency.