The Deadly Duo-A Combination of Allergy and Acute Coronary Syndrome A Case of Kounis Syndrome Type 1.

Kounis syndromewas first described by Kounis and Zavras in 1991, as the concurrent occurrence ofacute coronary events with an allergic or a hypersensitivity response. Mast cell activation and release ofinflammatory mediators have shown to induce coronary spasm, plaque erosion and even stent thrombosis.A 41 years old male, smoker was admitted with chest discomfort and features suggestive of myocardialinfarction. His ECG showed ST elevation and T inversion in I, aVL. High sensitive troponin I was elevatedand echocardiogram was normal. Four days ago, he had a history of redness and itching all over the bodyand was treated for allergic dermatitis. He had a family history of urticaria also. Coronary angiogramrevealed no major flow limiting coronary artery disease. Kounis syndrome type 1 was diagnosed and he wasdischarged on oral steroids and cardiac drugs. We always have to think of Kounis syndrome when treatinga young patient with allergy or anaphylaxis and concurrent acute coronary syndrome. Prompt recognition isimportant as treatment is significantly different.