Anaphylactic cardiovascular collapse manifesting as myocardial infarction following salad consumption. A case of Kounis variant type I syndrome

Anaphylactic cardiovascular events constitute an underrated cause of medical emergencies in hos-pitalized patients. Coronary arteries and myocardium are targeted by anaphylactic mediators leading to acute coronary syndrome and imminent cardiovascular collapse. Early diagnosis and high clinical suspicion are re-quired to secure prompt life-saving treatment in these cases. However, physicians of both Cardiology and In-ternal Medicine Departments are not familiar with this condition. Recently, we diagnosed and treated a case of anaphylactic cardiovascular collapse manifesting as acute myocardial infarction following salad consump-tion. Notably, Kounis anaphylaxis-associated acute coronary syndrome is a rare cause of ST segment eleva-tion myocardial infarction with normal or diseased coronary arteries. We recommend that Kounis syndrome and its variants should be taken into consideration in the differential diagnosis of ischemic heart disease in patients with signs of allergic reaction and/or medical history of previous allergic reactions, who experience acute coronary syndrome after exposure to certain environmental stimuli. (www.actabiomedica.it)