Acute coronary syndromes after hymenoptera stings and other environmental exposures are referred to as the Kounis syndrome or allergic myocardial ischemia and infarction. We report a case of a 53-year-old man with clinical features of acute coronary syndrome with transient ST segment elevation after a wasp sting. The management of this syndrome may be challenging for clinicians, and no guidelines are available. Based on the literature we propose the main factors to diagnose and treat the syndrome.
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