{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T09:58:19Z","timestamp":1773827899464,"version":"3.50.1"},"reference-count":24,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p> A 47-y-old man was bitten by a hump-nosed viper (Hypnale zara) and gradually developed retrosternal chest pain associated with ST segment elevation on electrocardiogram. He had normal troponin I levels and no evidence of coagulopathy. Initially, he was managed as having anterior ST elevation myocardial infarction with thrombolysis. Later, because troponin levels were normal, he was suggested to have the type I variant of Kounis syndrome (allergic coronary artery spasm). This was supported by high eosinophil counts in peripheral blood. He was successfully managed with supportive treatment and discharged 6 d after the snakebite. Cardiac complications are rarely reported after hump-nosed viper bites, and clinical reports of coronary vasospasm after snakebites are extremely rare in the literature. This is the first known report of Kounis syndrome after a hump-nosed viper bite. <\/jats:p>","DOI":"10.1016\/j.wem.2020.12.006","type":"journal-article","created":{"date-parts":[[2021,3,27]],"date-time":"2021-03-27T01:52:04Z","timestamp":1616809924000},"page":"210-216","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Kounis Syndrome Following <i>Hypnale zara<\/i> (Hump-Nosed Pit Viper) Bite in Sri Lanka"],"prefix":"10.1177","volume":"32","author":[{"given":"R.M.M.K.","family":"Namal Rathnayaka","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Teaching Hospital Ratnapura, Sri Lanka"},{"name":"Department of Pharmacology, Faculty of Medicine, Sabaragamuwa University of Sri Lanka, Hidellana, Ratnapura"},{"name":"Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peredeniya, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.E. 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