Kounis syndrome

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Background

Acute coronary syndromes associated with mast cell activation (anaphylaxis or anaphylactoid reaction). Also known as Coronary hypersensitivity disorder.[1]

Clinical Features

  • Stent thrombosis is the main manifestation of Kounis syndrome due to the mast cell infiltration of areas protected by drug-eluting stents[2]
  • ECG changes will correlate with the anatomical region of ischemia

Differential Diagnosis

Chest pain

Critical

Emergent

Nonemergent

Elevated Troponin

True Positive

False (Non-CAD) Positives

Evaluation

Intensity of treatment should be based on ACS likelihood

Workup

Diagnosis

  • Standard ACS workup
  • Serum IgE levels may be elevated

Management

Disposition

  • Admission for monitoring with cardiology consult

See Also

External Links

References

  1. Kounis N. Coronary hypersensitivity disorder: The Kounis syndrome. Clin Ther. 2013 May;35(5):563-71
  2. Kounis NG. Kounis syndrome should be considered the culprit cause of the most feared stent thrombosis. J Am Coll Cardiol. 2011;58:885.