Kounis Syndrome Presenting as Very Late Stent Thrombosis in an Everolimus-Eluting Stent Following Wasp Stings

• Published in: Korean circulation journal Vol. 43; no. 8; pp. 561 - 564
• Main Authors: Min, Jung Hwa, Kang, Min-Ho
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Cardiology 01.08.2013; 대한심장학회
• Subjects: Case Report; 내과학; Acute coronary syndrome; Thrombosis; Hypersensitivity; Drug-eluting stent
• ISSN: 1738-5520; 1738-5555
• DOI: 10.4070/kcj.2013.43.8.561

Kounis syndrome is the concurrence of acute coronary syndromes with conditions associated with mast cell activation following an allergic insult. We report a 56-year-old man who experienced a ST-segment elevation myocardial infarction after wasp stings. The patient presented without signs of anaphylaxis or shock. Coronary angiography showed an everolimus-eluting stent thrombosis (ST) of the left anterior descending artery occluding the vessel completely which was deployed for stable angina 3 years ago. The patient had been compliant with anti-platelet therapy, and no relevant cardiovascular events occurred until the day of admission. We interpreted our patient's condition as a manifestation of Kounis syndrome. To our knowledge, this is the first case of Kounis syndrome showing very late ST in a second-generation drug-eluting stent caused by wasp stings.