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

• Korean Circ J
• v.43(8); Aug 2013
• PMC3772302

Korean Circ J. 2013 August; 43(8): 561–564.

Published online 2013 August 31. doi:  10.4070/kcj.2013.43.8.561

PMCID: PMC3772302

Jung Hwa Min, MD and Min-Ho Kang, MD

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Abstract

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.

Keywords: Hypersensitivity, Drug-eluting stent, Thrombosis, Acute coronary syndrome

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