Kounis syndrome is a type of acute coronary syndrome that occurs when a chemical mediator produced by mast cell activation leads to coronary artery vasospasm. This can happen due to anaphylaxis, anaphylactoid reactions, allergies, or hypersensitivities. There are three variants of Kounis syndrome, including vasospastic allergic angina, an atheromatous disease with plaque eruption, and stent thrombosis. In this case, the patient developed type 2 Kounis syndrome after consuming a fish meal, which caused him to present with a non-ST elevation myocardial infarction (NSTEMI) at our hospital.
