Kounis syndrome without systemic allergy: A subtle presentation of stent thrombosis

Authors

Giovanni Paolella, Advocate Health - MidwestFollow
Viktoriya Bikeyeva, Advocate Health - MidwestFollow
Mae Leef, Advocate Health - MidwestFollow
George C. Michalopoulos, Advocate Health - MidwestFollow
Joseph Adams, Advocate Health - MidwestFollow
Andrii Labchuk, Advocate Health - MidwestFollow
Adib Chaus, Advocate Health - MidwestFollow

Recommended Citation

Paolella G, Bikeyeva V, Leef M, et al. Kounis Syndrome Without Systemic Allergy: A Subtle Presentation of Stent Thrombosis. Cureus. 2025;17(5):e84638. Published 2025 May 22. doi:10.7759/cureus.84638

Affiliations

Advocate Lutheran General Hospital

Abstract

Kounis Syndrome, or allergic acute coronary syndrome, is a rare cause of myocardial ischemia triggered by hypersensitivity reactions. Type III Kounis Syndrome, involving in-stent thrombosis following an allergic insult, is particularly rare and underrecognized. We report the case of a 67-year-old woman with a known contrast allergy who developed inferior ST-elevation myocardial infarction (STEMI) complicated by early stent thrombosis, suspected to be due to type III Kounis Syndrome. This case underscores the importance of maintaining a high index of suspicion for allergic triggers in acute coronary syndromes and considering contrast-sparing strategies in high-risk individuals.

Type

Article

PubMed ID

40546567