A Rare Case Report of Type II Kounis Syndrome With Literature Review: Acute Anterior ST Elevation Myocardial Infarction Following Bee Sting

Kounis syndrome (KS), also known as allergic angina, is a rare but serious condition defined by acute coronary syndrome occurring alongside a hypersensitivity reaction. We report the case of a 42-year-old male smoker who developed Type II KS after a hymenoptera sting. The patient came to the emergency department with a sudden decreased level of consciousness and retrosternal chest pain. Electrocardiography showed ST-segment elevation in the anterior leads, and coronary angiography revealed total proximal left anterior descending artery occlusion. Primary percutaneous coronary intervention (PCI) was performed successfully. Echocardiography documented a left ventricular ejection fraction (LVEF) of 35% with regional wall motion abnormalities, indicating significant myocardial injury. The patient was discharged with a treatment plan that included valsartan, spironolactone, bisoprolol, ticagrelor, acetylsalicylic acid, and atorvastatin. This case highlights the diagnostic and treatment challenges of KS and stresses the need for early recognition and a team-based approach to achieve better clinical results.