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From Acute Carditis, Rheumatic Carditis, and Morphologic Cardiac Reactions to Allergic Angina, Allergic Myocardial
Nicholas G Kounis1, Alexandros Stefanidis2, Ming-Yow Hung3,4,5
1Department of Medicine, Division of Cardiology, University Hospital of Patras, 26500 Patras, Greece.
Journal of Cardiovascular Development and Disease
|September 26, 2025
Summary
Kounis syndrome is a cardiovascular issue linked to hypersensitivity reactions and mast cell activation. COVID-19 and its vaccination can trigger this syndrome through inflammatory pathways.
Area of Science:
- Cardiology
- Immunology
- Allergy
Background:
- Kounis syndrome involves hypersensitivity reactions affecting the cardiovascular system.
- It is associated with mast cell activation and inflammatory mediators.
Purpose of the Study:
- To review the history, mechanisms, and current understanding of Kounis syndrome.
- To explore the impact of COVID-19 and vaccination on Kounis syndrome.
Main Methods:
- Narrative review of existing literature.
- Discussion of allergic and nonallergic cardiovascular events.
- Analysis of inflammatory pathways and mediators.
Main Results:
- Kounis syndrome affects coronary, cerebral, and other vascular systems.
- Mast cell activation releases mediators like tryptase and histamine.
- COVID-19 infections involve mast cell activation and proinflammatory cytokines.
Conclusions:
- Kounis syndrome is a distinct acute vascular disease.
- COVID-19 and its vaccination are linked to Kounis syndrome through mast cell activation.
- Understanding these pathways is crucial for managing cardiovascular events in hypersensitivity.
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