Kounis Syndrome: Allergic Vasospastic Cardiac Event

Kounis syndrome (KS) is an acute coronary event secondary to an allergic reaction. It is provoked by environmental agents, food, and medications. KS is caused by the release of allergic mediators. We are reporting a case of a 39-year-old man who had a syncopal episode after he took cephalexin and ibuprofen for toothache. He developed chest pain and erythematous rash later. His electrocardiography did not show any ST-segment elevation changes and cardiac troponins were elevated. He was started on the acute coronary syndrome treatment protocol. Coronary angiography revealed no significant obstructive or culprit lesions. The patient was discharged home in stable condition. He is advised to adhere to lifestyle modification and outpatient follow-up with cardiology and allergy/immunology. KS is infrequently reported in the medical literature. Physicians should pay attention to any allergic reaction preceding the acute cardiac event and consider KS in the differential diagnosis.