Day 0 (admission date) | A 65-year-old male patient presents with an anaphylactic cardiovascular collapse, successfully treated by IV corticosteroids, anti-histamines and fluids. |
Day 1 | He develops a severe epigastric pain attributed to ST-segment elevation myocardial infarction in the inferior electrocardiogram leads. |
Within 4 h | Transfer to specialized cardiac catheterization centre. Coronary angiography shows a significant stenosis of hypoplastic right coronary artery and an uncertain culprit distal occlusion on the left posterior descending artery. Ventriculogram reveals an akinesia of the infero-median wall. |
Day 2 | Enhanced cardiac magnetic resonance imaging shows an acute transmural myocardial necrosis on the infero-median segment and an acute sub-endocardial necrosis on the infero-septo-basal segment. Diagnosis of Type II Kounis syndrome treated with dual antiplatelets, statins, amlodipine, and avoiding beta-blockers. |
3 months after hospital discharge | Asymptomatic patient with good clinical performance for daily activities. |