# Kounis Syndrome Type 2 due to Ingestion of a Fish Meal: A Case Report

## TL;DR

A patient developed a rare heart condition after eating a fish meal, leading to a heart attack.

## Contribution

This case report documents a rare instance of Kounis Syndrome Type 2 triggered by a fish meal.

## Key findings

- The patient presented with NSTEMI following a fish meal.
- The case highlights Kounis Syndrome Type 2 as a possible cause of acute coronary events.
- Mast cell activation from the meal likely caused coronary vasospasm.

## Abstract

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.