Kounis syndrome: terra incognita

Abstract

The most common cause of death in the world is acute disorders of coronary blood circulation, and allergic diseases, which are progressively increasing, are recognized as a «disease of civilization». Kounis syndrome is a pathology characterized by coronary disorders against the background of hypersensitivity caused by various conditions (medications, environmental influences, food, coronary stents, etc.). Vasospastic allergic angina, allergic myocardial infarction, and stent thrombosis with occlusive thrombus infiltrated with eosinophils and/or mast cells are three variants of this syndrome. In Ukraine, clinical cases of Kounis syndrome have not been described, which is explained by low awareness and, accordingly, insufficient alertness of the medical community. Purpose - to acquaint the medical community with the etiology, pathogenetic mechanisms, features of clinical manifestations and modern diagnostic methods of Kounis syndrome. The article presents a review of modern literature sources that describe the prevalence, most common causes, mechanisms of development, clinical manifestations, and management of various variants of Kounis syndrome. Conclusions. Kounis syndrome is a common pathology characterized by the development of coronary blood circulation disorders against the background of allergic diseases. In the presence of any allergic pathology (especially during an exacerbation), a search for signs of coronary circulation disorders (еlectrocardiography, determination of the level of troponins and other cardiac enzymes) should be conducted for the purpose of timely diagnosis and treatment of Kounis syndrome. To predict the risk of development and recurrence of Kounis syndrome, it is recommended to study the allergic profile of the patient and cardiological risk factors already in childhood (conducting the multicomponent Alex test, determining the lipid profile, еlectrocardiography after allergic provocation), studying the genome. To prevent the occurrence and recurrence of Kounis syndrome, patients with allergic pathology should follow basic therapy to achieve control over inflammation. No conflict of interests was declared by the authors.