# Acetaminophen-Induced Type II Kounis Syndrome: A Case Report Highlighting Diagnostic Challenges and the Utility of a Physician-Staffed Rapid Response Car

**Authors:** Satoshi Hashiguchi

PMC · DOI: 10.7759/cureus.104346 · 2026-02-26

## TL;DR

An 85-year-old man developed a rare heart condition after taking acetaminophen, and a mobile medical team helped save his life by acting quickly.

## Contribution

Highlights the role of physician-staffed rapid response cars in diagnosing and managing rare drug-induced heart emergencies.

## Key findings

- Acetaminophen triggered Type II Kounis Syndrome with total coronary artery blockage.
- A rapid response car enabled early STEMI diagnosis and timely emergency treatment.
- Advanced pre-hospital systems can resolve therapeutic conflicts in Kounis Syndrome.

## Abstract

Kounis syndrome (KS) is a clinical condition where anaphylaxis induces acute coronary syndrome. This report describes a case of Type II KS in an 85-year-old male, triggered by intravenous acetaminophen, resulting in total occlusion of the right coronary artery. The intervention of a physician-staffed rapid response car (RRC) facilitated early pre-hospital diagnosis of ST-segment elevation myocardial infarction (STEMI). This enabled an integrated transition to emergency percutaneous coronary intervention (PCI). The case demonstrates the utility of advanced pre-hospital systems in managing the therapeutic conflicts associated with KS.

## Linked entities

- **Chemicals:** acetaminophen (PubChem CID 1983)
- **Diseases:** acute coronary syndrome (MONDO:0005542), ST-segment elevation myocardial infarction (MONDO:0041656), myocardial infarction (MONDO:0005068)

## Full-text entities

- **Diseases:** anaphylaxis (MESH:D000707), KS (MESH:D000074962), occlusion of the right coronary artery (MESH:D054059), ST-segment elevation myocardial infarction (MESH:D000072657), acute coronary syndrome (MESH:D054058)
- **Chemicals:** Acetaminophen (MESH:D000082)

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13033107/full.md

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Source: https://tomesphere.com/paper/PMC13033107