Cardiovascular Medicine Book

Coronary Artery Disease

  • Allergic Acute Coronary Syndrome


Allergic Acute Coronary Syndrome

Aka: Allergic Acute Coronary Syndrome, Kounis Syndrome, Allergic Angina
  1. Definitions
    1. Kounis Syndrome
      1. Acute Coronary Syndrome triggered by an Allergic Reaction
  2. Epidemiology
    1. Seen in ~1% of patients admitted with Allergic Reaction
  3. Pathophysiology
    1. First described in 1991 by Nicholas Kounis
    2. Allergic Reaction cascade involving Mast Cell activation, histamine release and Platelet aggregation
      1. Inflammatory reaction results in Coronary ArteryPlaque rupture resulting in Acute Coronary Syndrome
      2. Vasospasm may also be present
  4. Findings
    1. Acute Coronary Syndrome onset within 1 hour of Allergic Reaction in 80% of cases
  5. Types
    1. Type 1: Vasospasm only
    2. Type 2: Vasospasm AND coronary thrombosis
    3. Type 3: Vasospasm AND stent thrombosis
  6. Management
    1. Manage as Acute Coronary Syndrome
    2. Manage Anaphylaxis
      1. Exercise caution with Anaphylaxis management that may provoke coronary disease (e.g. Epinephrine)
      2. Exercise caution with Acute Coronary Syndrome management that may provoke Allergic Reaction
        1. Beta Blockers may blunt Epinephrine response and Morphine (and other Opioids) may release histamine
  7. References
    1. Mattu and Demeester in Herbert (2021) EM:Rap 21(6): 3-4
    2. Kounis (1991) Br J Clin Pract 45:121-8 [PubMed]
    3. Memon (2015) Proc (Bayl Univ Med Cent) 28(3):358-62 [PubMed]

Kounis syndrome (C2609176)

Concepts Disease or Syndrome (T047)
English Kounis syndrome
Spanish Síndrome de Kounis
Portuguese Síndrome de Kounis
Dutch Kounis-syndroom
Italian Sindrome di Kounis
French Syndrome de Kounis
German Kounis-Syndrom
Czech Kounisův syndrome
Japanese コーニス症候群, コーニスショウコウグン
Hungarian Kounis-syndroma
Derived from the NIH UMLS (Unified Medical Language System)

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