A case of type I variant Kounis syndrome with Samter-Beer triad

Abstract

Kounis syndrome is defined as the coexistence of acute coronary syndromes with situations associated with allergy or hypersensitivity, as well as anaphylactic or anaphylactoid reactions, to a variety of medical conditions, environmental and medication exposures. We report a case of Kounis-Zavras syndrome type I variant in the setting of aspirin-induced asthma, or the Samter-Beer triad of asthma, nasal polyps and aspirin allergy. When there is a young individual with no predisposing factors of atherosclerosis and apparent coronary lesion, with or without electrocardiography and biochemical markers of infarction, the possibility of Kounis syndrome should be kept in mind.

Keywords: Kounis syndrome; Samter-Beer triad; Nasal polyps; Coronary spasm; Aspirin allergy

Core tip: When there is a young individual with no predisposing factors of atherosclerosis and apparent coronary lesion, with or without electrocardiography and biochemical markers of infarction, the possibility of Kounis syndrome should be kept in mind. In such a situation, intracoronary vasodilators, nitrates, nicorandil or diltiazem should be used before proceeding with a coronary intervention. An urgent eosinophil count should be done before proceeding with a coronary intervention to rule out coronary spasm.