A Case Report of Kounis Syndrome in Guyana

Background: Kounis Syndrome is a fascinating and relatively rare condition that bridges the domains of Allergic Reactions and Coronary Artery Disease. It is defined as Acute Coronary Syndrome (ACS) occurring in the setting of an Allergic Reaction or Anaphylaxis and is associated with mast cell and platelet activation. The triggers for Kounis Syndrome are many but the most common includes Drugs, Foods and Environmental Exposures. There are three variants of Kounis Syndrome characterized by their pathophysiologic mechanisms and include coronary artery vasospasm, plaque erosion or rupture and stent thrombosis respectively. Case report: This was a single case presentation in which a 70-year-old female patient presented to the Accident and Emergency after being stung by many bees with complaints of abdominal pain and vomiting. A diagnosis of Anaphylaxis was made and the appropriate treatment was given. Due to routine workup of critical patients, an EKG was done which showed ST elevations in the inferior leads with reciprocal changes in the anterior and lateral leads. This patient never complained about any chest pain or epigastric discomfort. A diagnosis of Kounis Syndrome was made however the patient signed out against medical advice so further investigation into what variant of Kounis she presented with could not be done. Conclusion: Kounis Syndrome is considered a rare condition but it may be more common than we realize. Its diagnosis or more specifically underdiagnosis may be largely due to it being unrecognized by physicians. Based on how this case presented, an EKG should be ordered for all patients presenting with Anaphylaxis as Kounis Syndrome further complicates and worsens the outcomes of these patients. Keywords: (Kounis Syndrome, Allergic Reaction, Coronary Artery Disease, Acute Coronary Syndrome, Anaphylaxis, Allergic Angina, Guyana)