When allergy strikes the heart: Kounis syndrome and cardiac arrest

Kounis syndrome should be considered in young patients presenting with acute coronary syndromes and non-obstructive coronary arteries, especially when symptoms occur after exposure to drugs or allergens.Type I Kounis syndrome, despite the absence of structural coronary artery disease, may be complicated by life-threatening ventricular arrhythmias, underscoring that it is not always a benign condition.A detailed allergological and pharmacological history is crucial in patients with suspected myocardial infarction with nonobstructive coronary arteries to avoid misdiagnosis, prevent repeated exposure to triggering agents such as non-steroidal anti-inflammatory drugs, and guide appropriate multidisciplinary management.