ST-Segment Elevation Myocardial Infarction (STEMI) With a Fishy Twist: A Case of Kounis Syndrome Following Seafood Ingestion.

Kounis syndrome is an underrecognized condition characterized by the concurrence of acute coronary syndrome (ACS) and a hypersensitivity reaction mediated by mast cell activation. Diagnosis can be challenging, and treatments for anaphylaxis and ACS may have competing effects. We report a case of a 58-year-old male who presented with anaphylaxis after seafood ingestion, complicated by anterior ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed plaque rupture with thrombus in the mid-left anterior descending artery, consistent with type II Kounis syndrome. This case highlights the importance of early recognition and management to balance treatment of both allergic and ischemic processes.