{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T22:15:04Z","timestamp":1777414504425,"version":"3.51.4"},"reference-count":8,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,12,15]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>Acute coronary syndrome occurring during the course of a type I hypersensitivity reaction constitutes Kounis syndrome. We report a case of a 64-year-old man who presented with a non-ST elevation myocardial infarction and peripheral blood eosinophilia. He had rhinitis and constitutional symptoms for several days prior to presentation. Blood investigations revealed moderate eosinophilia and elevated IgE levels. A cardiac MRI showed generalised oedema with a subtle wall motion abnormality in basal inferior\/inferolateral wall, and subendocardial high signal on late gadolinium enhancement suggesting a localised myocardial infarction. A coronary angiogram then revealed triple vessel disease. A diagnosis of Kounis syndrome was made. Within days of starting appropriate treatment, the patient\u2019s eosinophil count returned to normal with improvement of clinical picture.<\/jats:p>","DOI":"10.1136\/bcr-2019-232472","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T04:55:22Z","timestamp":1577163322000},"page":"e232472","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Kounis syndrome uncovers severe coronary disease: an unusual case of acute coronary syndrome secondary to allergic coronary vasospasm"],"prefix":"10.1136","volume":"12","author":[{"given":"Luca","family":"Conti","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9877-4658","authenticated-orcid":false,"given":"Kelly","family":"Gatt","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Zammit","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Cassar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,23]]},"reference":[{"key":"2025082703224630000_12.12.e232472.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2013.02.022"},{"key":"2025082703224630000_12.12.e232472.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2005.08.007"},{"key":"2025082703224630000_12.12.e232472.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-012-1351-7"},{"key":"2025082703224630000_12.12.e232472.4","doi-asserted-by":"crossref","first-page":"225","DOI":"10.4081\/itjm.2019.1189","article-title":"Comparison of aeroallergen sensitization patterns in the United States and Europe","volume":"13","author":"Conti","year":"2019","journal-title":"Ital J Med"},{"key":"2025082703224630000_12.12.e232472.5","doi-asserted-by":"publisher","DOI":"10.1038\/nm1601"},{"key":"2025082703224630000_12.12.e232472.6","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4274\/balkanmedj.galenos.2019.2019.5.62","article-title":"Kounis Syndrome\u2014not a Single-organ arterial disorder but a multisystem and multidisciplinary disease","volume":"36","author":"Kounis","year":"2019","journal-title":"Balkan Med J"},{"key":"2025082703224630000_12.12.e232472.7","article-title":"Myocardial infarction associated with eosinophilia and plasma extravasation at multiple sites. A variant of Kounis syndrome","volume":"2015","author":"Gunawardena","year":"2015","journal-title":"Case Reports"},{"key":"2025082703224630000_12.12.e232472.8","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ejim.2015.12.004","article-title":"Kounis syndrome: a concise review with focus on management","volume":"30","author":"Fassio","year":"2016","journal-title":"Eur J Intern Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-232472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:22:53Z","timestamp":1756290173000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-232472"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":8,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2019,12,23]]},"published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1136\/bcr-2019-232472"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-232472","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12]]}}}