Abstract
Kounis syndrome defined as the occurrence of acute coronary syndrome in the setting
of allergic reaction due to mast cells activation and inflammatory mediators release
that induces coronary vasospasm, plaque erosion, or even stent thrombosis. A 25-year-old
postpartum female with asthma and recurrent episodes of chest pain was admitted with
ST-segment elevation myocardial infarction in the setting of coronary artery spasms.
The patient was started on calcium channel blockers and nitrite-based medication with
no improvement. She was noted to have eosinophilia and initiation of corticosteroid-based
regimen lead to resolution of chest pain episodes and normalization of eosinophilia.
Kounis syndrome should be considered in young patients with chest pain. Coronary vasodilators
are considered as the first-line of treatment. The use of corticosteroids has been
described in the literature in severe or refractory cases.
Keywords
Allergic coronary artery syndrome - coronary artery vasospasm - Kounis syndrome
