Introduction:

Kounis syndrome (KS) is myocardial ischemia secondary to the release of inflam matory mediators (mastocyte degranulation) during an allergic reaction. Adult anaphylaxis is often triggered by medications, of which antibiotics are the most frequently reported.

Objective:

to study the presentation of and clinical approach to a patient with Kounis syndrome and increase the diagnostic suspicion of a disease which does not have a standardized treatment and is not supported by clinical practice guidelines.

Case presentation:

we present the case of a 62-year-old adult patient with chest pain and anginal equivalents following perioperative anaphylactic shock during a scheduled open cholecystectomy for gallstones, with subsequent acute myocardial infarction without ST elevation, and coronary artery lesions or atheromatous disease ruled out by arteriography.

Conclusions:

Kounis syndrome is an underdiagnosed entity with a variable clinical presenta tion and no concrete or standardized treatment. This therefore encourages the development of a greater case history and the structuring of widely disseminated guidelines for its treatment. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2289).

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