Podcast 697: Kounis Syndrome - The Emergency Medical Minute

Podcast 697: Kounis Syndrome

Contributor: Aaron Lessen, MD

Educational Pearls:

  • Kounis syndrome is an allergic acute coronary syndrome
  • Triggers include medications (antibiotics), insect bites, or other common allergens
  • Believed to be due to mast cell activation, inflammatory cytokines, and platelet activation causing coronary vasospasm or plaque rupture in setting of existing atherosclerosis
  • Consider Kounis syndrome in the setting of chest pain in anaphylaxis
  • Treatment involves treatment of allergic reaction, although epinephrine should be used cautiously
  • Avoid morphine as this can cause mast cell activation


Kounis NG. Kounis syndrome: an update on epidemiology, pathogenesis, diagnosis and therapeutic management. Clin Chem Lab Med. 2016;54(10):1545-1559. doi:10.1515/cclm-2016-0010

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