Allergic Acute Coronary Syndrome Without Identifiable Triggers – Kounis Syndrome Type I Associated with Chronic Spontaneous Urticaria. Case Report and Review of the Literature
Abstract
Introduction
Kounis syndrome is a complex clinical entity at the intersection of acute coronary syndromes and allergic reactions.
Case presentation
We report the case of a 55-year-old woman with hypertension, autoimmune thyroiditis, and recurrent allergic complaints who was admitted with ST-elevation myocardial infarction and found to have myocardial infarction with non-obstructive coronary arteries (MINOCA), likely due to coronary vasospasm. During hospitalization, she developed cutaneous symptoms and was subsequently diagnosed with chronic spontaneous urticaria. Retrospectively, the diagnosis of Kounis syndrome type I was established.
Conclusions
Reporting cases with subtle or absent allergic manifestations is essential to improve diagnostic accuracy and guide appropriate management, particularly given the potential for recurrence.
© 2025 Maria Andreea Micu, Dan Alexandru Cozac, Diana Ioana Prația-Aron, Cosmin Macarie, Corina Ureche, published by Asociatia Transilvana de Terapie Transvasculara si Transplant KARDIOMED
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