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Kounis Syndrome: Report Of Two Cases With Peculiar Presentation And Diagnostic Issues

A. Maloberti, F. Pansera, O. Sala, R. Fusco, A. Pierri, I. Bossi, C. Giannattasio
Published 2019 · Biology, Medicine

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Kounis Syndrome (KS) is a coronary spasm caused by an allergic reaction that leads to myocardial ischemia or infarction [1]. The main pathological mechanism of KS is the epicardial coronary artery vasospasm due to the release of inflammatory mediators during the allergic reaction. These release is determined by the degranulation and activation of mast cells of the coronary artery wall, leading to vasospasm, erosion/rupture of atherosclerotic plaques or intrastent thrombosis, depending on the coronary anatomy [2]. The first case of association between acute coronary events and allergic reactions has been reported in 1950 [3]. From that paper, few case series and prospective studies [4] has been published. Since it is an uncommon cause of acute cardiac events and, even more, it frequently goes unnoticed, many gaps in evidence are still presents [1]. Starting from its prevalence estimation and going to the therapeutic option through the diagnostic issues still many questions need to be answered. Here we present two cases of KS with peculiar clinical presentation and diagnostic issues. 2 Case Report 1
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