ReviewBMC cardiovascular disorders2018
Acute coronary syndrome secondary to allergic coronary vasospasm (Kounis Syndrome): a case series, follow-up and literature review.
Review in BMC cardiovascular disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Bee sting-induced myocardial infarction: a systematic review with illustrative case.BMC cardiovascular disorders · 2025Pooled it
- Myocardial Infarction with Non-Obstructive Coronary Arteries: A Puzzle in Search of a Solution.Reviews in cardiovascular medicine · 2022Pooled it
- Kounis Syndrome in the Modern Era: A Comprehensive Review of Allergic Acute Coronary Syndromes.Journal of clinical medicine · 2026Review
- Kounis Syndrome in Cardiac Surgery: Pathophysiology, Antimicrobial Triggers, and Perioperative Recognition and Management.Medical sciences (Basel, Switzerland) · 2026Review
- Article
- Anti-vasospastic mast cell stabilizers: a novel therapeutic approach to anaphylaxis-induced acute coronary syndrome.Clinical and experimental vaccine research · 2025Article
- Triggers, Types, and Treatments for Kounis Syndrome: A Systematic Review.Clinics and practice · 2025Review
- Lenalidomide-induced type II Kounis syndrome: a case report.Frontiers in cardiovascular medicine · 2025Article
- Case Report: Anaphylactic shock and ST-elevation myocardial infarction following a bee sting: two deadly diseases in a patient with Kounis syndrome.Frontiers in cardiovascular medicine · 2025Article
- Article
- The curious case of Kounis syndrome: exploring clinical manifestations and management in the presence of nonobstructive coronary arteries.Global cardiology science & practice · 2024Article
- Unexpected cause of Kounis syndrome: hypersensitivity reaction to omeprazole.BMJ case reports · 2023Article
- Article
- Kounis Syndrome Associated With the Use of Diclofenac.Texas Heart Institute journal · 2023Review
- Identification of the biological processes, immune cell landscape, and hub genes shared by acute anaphylaxis and ST-segment elevation myocardial infarction.Frontiers in pharmacology · 2023Article
- Cases of allergic coronary syndrome (Kounis syndrome) : what we should know.Nagoya journal of medical science · 2022Article
- Type III Kounis Syndrome Secondary to Ciprofloxacin-Induced Hypersensitivity.Medicina (Kaunas, Lithuania) · 2022Article
- Article
- Acute coronary syndrome due to plaque erosion likely triggered by insect bites: a case series of Kounis syndrome.European heart journal. Case reports · 2022Article
- Coronary Artery Spasm: Risk Factors, Pathophysiological Mechanisms and Novel Diagnostic Approaches.Reviews in cardiovascular medicine · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKounis syndrome (KS) is the concurrence of acute coronary syndrome associated with mast-cell and platelet activation in the setting of hypersensitivity and allergic or anaphylactic insults. Many drugs and environmental exposures had been reported as inducers, but various inducers and the mechanism of KS remained unknown till now. The widely used traditional Chinese medicine (TCM) as a potential sensitizer were scarcely reported to induce allergic vasospasm due to the ignorance of the linkage between traditional medicine allergy and vasospasm. CASE PRESENTATION: We described 5 rare cases of KS including unreported triggers of TCM and abortion, reported the treatment strategy and 1~4 years' follow-up results, and tried to probe into the etiology of KS. Case 1 and case 2 for the first time reported acute ST-segment elevation myocardial infarction (STEMI) caused by Chinese herbs related allergic coronary vasospasm. Case 3 reported recurrent angina following allergen contact and wheezing, indicating the internal linkage of coronary vasospasm and allergic asthma. Case 4 described a childbearing-age woman suffered refractory ischemic chest pain due to coronary vasospasm in a special period of post-abortion, the attacks suddenly disappeared when her menopause recovered. Case 5 described an isolated episode of allergic coronary vasospasm under exposure of smoking and stress, which was successfully prevented by avoiding the exposures.
conclusionKounis syndrome is not rare but rarely recognized and under-diagnosed. It is necessary to recognize KS and various inducers, especially for the patients suffering refractory vasospastic cardiac attacks concentrating in special periods. Blood test of eosinophil might contribute to diagnose KS and anti-allergic agents might be helpful for controlling KS attacks.
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