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Lijec Vjesn. 2013 Mar-Apr;135(3-4):82-5.

[Acute coronary syndrome after hornet bite, type II Kounis syndrome - a case report].

[Article in Croatian]

Author information

Sluzba hitne medieinske pomoći, JZU Dom zdravlja s poliklinikom Dr Mustafa Sehović, Tuzla, Bosna i Hercegovina.


Kounis syndrome is an accidental occurrence of acute coronary syndrome associated with anaphylaxis, where acute inflammatory mediators cause the spasm of coronary arteries with the erosion and rupture of atheromatous plaque. We present a 53-year-old male who during the treatment of anaphylaxis after a hornet bite developed acute anteroseptal myocardial infarction. The diagnosis of type II Kounis syndrome was proven by electrocardiographic abnormalities and biochemical markers with clinical manifestation of acute coronary syndrome, and was associated with anaphylaxis which demanded prehospital treatment of the patient after the hornet bite. Anaphylaxis after a hornet bite requires consideration of acute coronary syndrome if patients have chest pain and hemodynamic impairment, as these conditions occur infrequently but demand additional diagnostics and adequate treatment.

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