A Unique Challenge in Management in the Emergency Department and Cardiac Cathlab: Case Review of Two Subjects with Kounis Syndrome Complicated with ST Elevation Myocardial Infarction and Ventricular Tachycardia, Following Exposure to Cutaneous or Intravenous Allergens

Acute coronary syndromes, such as spasm or acute myocardial infarction, have been reported following allergic reactions. These are known to affect patients of any age, and can a variety clinical manifestations, collectively referred Kounis syndrome [1]. We report 2 cases infarction complicated by severe cardiac dysrhythmia, an reaction cutaneous intravenous allergens. To our knowledge, this is the first instance skin contact with caterpillar has documented provoke STEMI polymorphic VT. Management could be hazardous, particularly in emergency units catheter labs, when decisions on drugs urgent revascularization need made background inflammation induced In theory, bare metal stents (when appropriate), Polymer free, Bio-absorbable scaffolds rapid healing Drug Eluting Stents offer better safety profile PCI, but according duration antiplatelet relative various types variable drug polymer combinations not formally evaluated condition randomised control trials. The risk early late stent thrombosis restenosis chronic may difficult predict long term, without follow up data from Such trials very set given low volumes nature events, hence review case series like ours will invaluable gain more insight into decision making required interesting syndrome. Reassuringly, both who had PCI either Biolimus, Everolimus eluting respectively setting, experienced repeat hospitalizations for ACS, arrhythmia procedure at 7 5year follow-ups respectively.