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Peer-reviewedCC BY-NC-NDClinical case reports

A Rare Case Report of Type II Kounis Syndrome With Literature Review: Acute Anterior ST Elevation Myocardial Infarction Following Bee Sting

  • Sara Tarkiani1
  • Mobina Ghajar1
  • Mohammad Hossein Sharifi Fard1
  • Mohammad Ghasemi Palangi1
  • Armin Bordbar1
  • Hassan Ahangar1
  • Amin Ramezani2
  1. 1Department of Cardiology, School of Medicine Zanjan University of Medical Science Zanjan Iran.
  2. 2Department of Medicine (HSRD), Baylor College of Medicine Houston Texas USA.
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Abstract

Kounis syndrome (KS), also known as allergic angina, is a rare but serious condition defined by acute coronary syndrome occurring alongside a hypersensitivity reaction. We report the case of a 42-year-old male smoker who developed Type II KS after a hymenoptera sting. The patient came to the emergency department with a sudden decreased level of consciousness and retrosternal chest pain. Electrocardiography showed ST-segment elevation in the anterior leads, and coronary angiography revealed total proximal left anterior descending artery occlusion. Primary percutaneous coronary intervention (PCI) was performed successfully. Echocardiography documented a left ventricular ejection fraction (LVEF) of 35% with regional wall motion abnormalities, indicating significant myocardial injury. The patient was discharged with a treatment plan that included valsartan, spironolactone, bisoprolol, ticagrelor, acetylsalicylic acid, and atorvastatin. This case highlights the diagnostic and treatment challenges of KS and stresses the need for early recognition and a team-based approach to achieve better clinical results.

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Cite

BibTeXRIS
BibTeX
@article{tarkiani2026rare,
  title = {{A Rare Case Report of Type II Kounis Syndrome With Literature Review: Acute Anterior ST Elevation Myocardial Infarction Following Bee Sting}},
  author = {Sara Tarkiani and Mobina Ghajar and Mohammad Hossein Sharifi Fard and Mohammad Ghasemi Palangi and Armin Bordbar and Hassan Ahangar and Amin Ramezani},
  journal = {Clinical case reports},
  year = {2026},
  month = oct,
  doi = {10.1002/ccr3.73799},
  url = {https://europepmc.org/article/PMC/PMC13717947},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - A Rare Case Report of Type II Kounis Syndrome With Literature Review: Acute Anterior ST Elevation Myocardial Infarction Following Bee Sting
AU  - Sara Tarkiani
AU  - Mobina Ghajar
AU  - Mohammad Hossein Sharifi Fard
AU  - Mohammad Ghasemi Palangi
AU  - Armin Bordbar
AU  - Hassan Ahangar
AU  - Amin Ramezani
PY  - 2026
DA  - 2026/10/29
JO  - Clinical case reports
DO  - 10.1002/ccr3.73799
UR  - https://europepmc.org/article/PMC/PMC13717947
AB  - Kounis syndrome (KS), also known as allergic angina, is a rare but serious condition defined by acute coronary syndrome occurring alongside a hypersensitivity reaction. We report the case of a 42-year-old male smoker who developed Type II KS after a hymenoptera sting. The patient came to the emergency department with a sudden decreased level of consciousness and retrosternal chest pain. Electrocardiography showed ST-segment elevation in the anterior leads, and coronary angiography revealed total proximal left anterior descending artery occlusion. Primary percutaneous coronary intervention (PCI) was performed successfully. Echocardiography documented a left ventricular ejection fraction (LVEF) of 35% with regional wall motion abnormalities, indicating significant myocardial injury. The patient was discharged with a treatment plan that included valsartan, spironolactone, bisoprolol, ticagrelor, acetylsalicylic acid, and atorvastatin. This case highlights the diagnostic and treatment challenges of KS and stresses the need for early recognition and a team-based approach to achieve better clinical results.
SN  - 2050-0904
ER  -