Kounis syndrome presenting with acute inferior wall myocardial infarction and cardiogenic shock secondary to intravenous ampicillin/sulbactam administration

Kounis syndrome (KS) is induced by allergic and anaphylactic reaction, and is considered a rare cause of coronary artery spasm (1) A 44-year-old male patient was admitted to our center with complaint of severe chest pain lasting for 1 hour. He was administered treatment of 1 g intravenous ampicillin/sulbactam with diagnosis of upper respiratory tract infection. He did not have history of allergy or traditional risk factors for coronary artery disease. Ten minutes after the injection, he felt severe, squeezing retrosternal chest pain. On physical examination, he was pale. He did not have pruritus or rash. His blood pressure (BP) and heart rate were 77/48 mm Hg and 104 bpm, respectively. Anatol J Cardiol 2016; 16: 889-96 Letters to the Editor 893