Rathnayaka et al reported a case of Kounis syndrome (allergic coronary artery spasm) following the bite of a hump-nosed viper (Hypnale zara). The authors are from University of Peradeniya and Teaching Hospital Ratnapura in Sri Lanka.
Implicated snakes: hump-nosed viper, cobra, other vipers
Clinical features:
(1) recent snakebite
(2) onset of chest pain
(3) elevated ST-segment
(4) normal to elevated serum troponin concentration
(5) elevated absolute eosinophil count
(6) exclusion of other causes
Typically coronary angiography does not show a significant occlusion.
It may also occur due to an allergic reaction to antivenom.
Kounis syndrome may also be triggered by other toxic bites (scorpions, fire ant, hornet, other).
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