Bibiana A. Vargas-Caballero, Departamento de Investigación, Hospital Regional de la Orinoquía, Yopal, Colombia
Magda A. Fonseca-Rodríguez, Departamento de Investigación, Hospital Regional de la Orinoquía, Yopal, Colombia
Giselle A. Naranjo-Villate, Departamento de Investigación, Hospital Regional de la Orinoquía, Yopal, Colombia
Ledmar J. Vargas-Rodríguez, Departamento de Investigación, Hospital Regional de la Orinoquía, Yopal, Colombia
Lorena García-Agudelo, Departamento de Investigación, Hospital Regional de la Orinoquía, Yopal, Colombia
Kounis syndrome is an acute coronary syndrome precipitated by a hypersensitivity reaction, mediated by mast cell activation and the release of proinflammatory mediators, with potential multisystem involvement. We present the case of a 79-year-old man with hypertension and carotid atheromatosis who, after receiving intravenous metamizole, developed an anaphylactic reaction complicated by cardiorespiratory arrest and Kounis-type acute coronary syndrome. He required advanced resuscitation, and subsequently, catheterization revealed three-vessel disease with significant coronary artery stenosis. This case highlights the importance of maintaining a high index of diagnostic suspicion in cases of acute coronary syndrome in the context of anaphylaxis.
Keywords: Anaphylaxis. Coronary vasospasm. Hypersensitivity. Kounis syndrome. Acute coronary syndrome.