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Emergency Medical Minute


Jul 26, 2021

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


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