Article Text
Abstract
Acute coronary syndrome occurring during the course of a type I hypersensitivity reaction constitutes Kounis syndrome. We report a case of a 64-year-old man who presented with a non-ST elevation myocardial infarction and peripheral blood eosinophilia. He had rhinitis and constitutional symptoms for several days prior to presentation. Blood investigations revealed moderate eosinophilia and elevated IgE levels. A cardiac MRI showed generalised oedema with a subtle wall motion abnormality in basal inferior/inferolateral wall, and subendocardial high signal on late gadolinium enhancement suggesting a localised myocardial infarction. A coronary angiogram then revealed triple vessel disease. A diagnosis of Kounis syndrome was made. Within days of starting appropriate treatment, the patient’s eosinophil count returned to normal with improvement of clinical picture.
- ischaemic heart disease
- interventional cardiology
- immunology
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Footnotes
Contributors LC: cared for patient; conception and design; interpretation of the data; drafting of the article; critical revision of the article for important intellectual content; final approval of the article. KG: conception and design; interpretation of the data; drafting of the article; critical revision of the article for important intellectual content; final approval of the article. CZ: cared for patient; critical revision of the article for important intellectual content; final approval of the article. KC: cared for patient; interpretation of the data; critical revision of the article for important intellectual content; final approval of the article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.