Background:

Kounis syndrome was described in 1991 as the simultaneous occurrence of acute coronary events and anaphylactic allergic reactions. Reports of clinical cases and series of small cases of angina triggered by allergic reactions have been reported for many years. It encompasses concepts such as allergic angina and allergic infarction.

Case report:

We report a case of a 47-year-old man with a history of fixed drug eruption for 10 years. The patient attended to the hospital with a moderate-intensity chest pain, electrocardiogram was performed which was compatible with acute coronary syndrome without ST-segment elevation; it progressed favorably with treatment by protocol. The subsequent study showed hypersensitivity to non-steroidal anti-inflammatory drugs and cardiovascular tests was negative, and it was concluded as a case of allergic angina.

Conclusions:

Kounis syndrome is a difficult to diagnose entity that requires a high index of suspicion in the evaluation of patients with chest pain in the Emergency Department.