Allergic myocardial infarction following recombinant human insulin.

BACKGROUND: Allergic myocardial infarction is a rare clinical entity.

OBJECTIVES: Although a few number of case reports with severe anaphylactic reactions to recombinant human insulin have been reported, allergic myocardial infarction, known as Kounis Syndrome, has not been reported before.

METHODS: Herein, we report a 57-year-old woman with myocardial infarction, referred for urticarial rash, chest pain, and palpitations developed after the first subcutaneous dose of recombinant human insulin.

RESULTS: The patient treated with antihistamines and steroids and discharged from hospital in a good condition.

CONCLUSIONS: Physicians should be aware of allergic myocardial infarction. The diagnosis of Kounis Syndrome should be entertained when allergic symptoms, electrocardiographic changes, and high cardiac enzymes accompany acute-onset chest pain. All patients admitted to the emergency department with chest pain and ST elevation on electrocardiography should be asked about allergic insults.