ReviewJournal of clinical medicine2025
Kounis Syndrome in Clinical Practice: Insights from Clinical Case Series and Mechanistic Pathways.
Review in Journal of clinical medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Bee sting-induced myocardial infarction: a systematic review with illustrative case.BMC cardiovascular disorders · 2025Pooled it
- Spectral cardiac CT in type 1 Kounis syndrome presenting as myocardial infarction with non-obstructive coronary arteries following anaphylactic shock.Radiology case reports · 2026Article
- Hornet Sting-Induced Type I Kounis Syndrome Presenting as a Non-ST-Elevation Acute Coronary Syndrome: A Case Report.Cureus · 2026Article
- Type II Kounis Syndrome Secondary to Amoxicillin Allergy.JACC. Case reports · 2026Article
- Article
- Contrast Media Side Effects and Kounis Syndrome: Timeo Danaos et Dona Ferentes.Balkan medical journal · 2026Review
- Disproportionality and Case-Based Evidence for a Possible Association Between Fluoroquinolones and Kounis Syndrome.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Kounis Syndrome Features in Special Populations.Medical sciences (Basel, Switzerland) · 2026Review
- Kounis Syndrome in Cardiac Surgery: Pathophysiology, Antimicrobial Triggers, and Perioperative Recognition and Management.Medical sciences (Basel, Switzerland) · 2026Review
- Kounis Syndrome Type II after Diclofenac Exposure: Unmasking a Link Between Drug Allergy and Acute Coronary Syndrome.Arquivos brasileiros de cardiologia · 2026Article
- A Rare Cause of Life-Threatening Chest Pain: Kounis Syndrome.Journal of cardiovascular development and disease · 2026Article
- When Allergy Strikes the Heart: Kounis Syndrome and Cardiac Arrest.European journal of case reports in internal medicine · 2026Article
- A harmless fang with harmful consequences: Kounis syndrome after a nonvenomous snakebite.Clinical and experimental emergency medicine · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Kounis syndrome (KS) is a rare condition where hypersensitivity reactions trigger coronary vasospasm, destabilization of atherosclerotic plaques, or stent thrombosis, posing diagnostic and therapeutic challenges due to its overlap with acute coronary syndrome (ACS) and the absence of specific guidelines. This study reviews cases of KS from the Institute of Cardiovascular Disease to highlight clinical presentations, triggers, and treatment strategies. We analyzed four cases of KS treated at our institution between 2019 and 2024. Detailed clinical histories, laboratory findings, imaging studies, and treatment plans were reviewed. Patients were classified by KS subtype based on coronary anatomy and pathophysiological mechanisms. Management strategies were tailored to each subtype, combining myocardial revascularization, antiplatelet therapy, and treatment for allergic reactions. The series included two cases of Type I KS in patients with structurally normal coronary arteries and two cases of Type II KS involving pre-existing atherosclerosis. No Type III KS was observed. Triggers included insect stings, antibiotics, iodinated contrast agents, and anesthetics. Coronary angiography confirmed the diagnosis in all cases. Treatments included percutaneous coronary interventions, dual antiplatelet therapy, and prophylactic antihistamines or corticosteroids. All patients experienced favorable outcomes, although diagnostic delays were noted in cases with atypical presentations. KS remains underdiagnosed, especially in emergency settings where it mimics ACS. Early recognition and multidisciplinary management involving allergology and cardiology are crucial. Future research should focus on safer diagnostic tools, understanding the pathophysiology, and developing evidence-based preventive strategies. Increasing the awareness of KS and its inclusion in ACS differentials are essential to improving patient outcomes and preventing recurrences.
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