title: Kounis syndrome, two case reports from Kragujevac, Serbia.
abstract: It is well-established that acute coronary syndromes occurs when thrombus formation from atheromatous plaques erode or rupture in the advanced stage of atherosclerotic process with severe reduction of coronary blood flow. Also, some conditions may trigger acute coronary syndrome even in the absence of prior cardiovascular disease, and with normal coronary vessels. One of the most important is Kounis syndrome, also known as "allergic angina" or "allergic myocardial infarction" in which the release of mediators during allergic insults has been incriminated to induce coronary artery spasm and/or atheromatous plaque erosion or rupture. The accurate incidence of Kounis syndrome is not known, but since it was described, many clinical cases have been reported, showing the occurence due to various allergens. Here we present two cases of most probable Kounis syndrome, first in patients after multiple stings by non-venomous insect called "black-fly".
authors.affiliation: Clinic of Cardiology, Clinical Center Kragujevac Kragujevac, Serbia.
authors.forename: Goran
authors.initials: G
authors.lastname: Davidovic
authors.affiliation: Clinic of Cardiology, Clinical Center Kragujevac Kragujevac, Serbia.
authors.forename: Violeta
authors.initials: V
authors.lastname: Iric-Cupic
authors.affiliation: Clinic of Cardiology, Clinical Center Kragujevac Kragujevac, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Zdravkovic
authors.affiliation: Faculty of Medical Sciences, University in Kragujevac Kragujevac, Serbia.
authors.forename: Srdjan
authors.initials: S
authors.lastname: Milanov
authors.affiliation: Faculty of Medical Sciences, University in Kragujevac Kragujevac, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Dimitrijevic
keywords: Kounis syndrome; anaphylactic reaction; black fly; myocardial ischemia