<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0188-2198</journal-id>
<journal-title><![CDATA[Revista mexicana de cardiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Mex. Cardiol]]></abbrev-journal-title>
<issn>0188-2198</issn>
<publisher>
<publisher-name><![CDATA[Asociación Nacional de Cardiólogos de México, Sociedad de Cardiología Intervencionista de México]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0188-21982018000100037</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Allergic myocardial ischemia secondary to ibuprofen, Kounis syndrome. Case report]]></article-title>
<article-title xml:lang="es"><![CDATA[Isquemia miocárdica alérgica secundaria a ibuprofeno, síndrome de Kounis. Reporte de un caso]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Torres]]></surname>
<given-names><![CDATA[Paúl Santiago]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Reyes]]></surname>
<given-names><![CDATA[Armel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lozada-Martínez]]></surname>
<given-names><![CDATA[Gabriela del Carmen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Pérez de Villa Amil]]></surname>
<given-names><![CDATA[Yelinnay]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villavicencio-Vélez]]></surname>
<given-names><![CDATA[María Gabriela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Ministerio de Salud Pública Hospital Provincial Puyo ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Ministerio de Salud Pública Hospital Provincial Puyo ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Ministerio de Salud Pública Hospital Provincial Puyo ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Ministerio de Salud Pública Hospital Provincial Puyo ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Ministerio de Salud Pública Hospital Provincial Puyo ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Ecuador</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2018</year>
</pub-date>
<volume>29</volume>
<numero>1</numero>
<fpage>37</fpage>
<lpage>40</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0188-21982018000100037&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0188-21982018000100037&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0188-21982018000100037&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Background: Kounis syndrome was described in 1991 as the simultaneous occurrence of acute coronary events and anaphylactic allergic reactions. Reports of clinical cases and series of small cases of angina triggered by allergic reactions have been reported for many years. It encompasses concepts such as allergic angina and allergic infarction.  Case report:  We report a case of a 47-year-old man with a history of fixed drug eruption for 10 years. The patient attended to the hospital with a moderate-intensity chest pain, electrocardiogram was performed which was compatible with acute coronary syndrome without ST-segment elevation; it progressed favorably with treatment by protocol. The subsequent study showed hypersensitivity to non-steroidal anti-inflammatory drugs and cardiovascular tests was negative, and it was concluded as a case of allergic angina.  Conclusions: Kounis syndrome is a difficult to diagnose entity that requires a high index of suspicion in the evaluation of patients with chest pain in the Emergency Department.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Antecedentes: El síndrome de Kounis fue descrito en 1991 como la aparición simultánea de eventos coronarios agudos y reacciones alérgicas anafilácticas. Casos clínicos y pequeñas series de casos de angina generada por reacciones alérgicas han sido reportados en varios años. Engloba conceptos como el de angina alérgica e infarto alérgico.  Caso clínico: Presentamos un caso clínico de un hombre de 47 años de edad, con antecedentes de eritema fijo medicamentoso desde hace 10 años. Acude al Departamento de Emergencia por presentar dolor torácico de moderada intensidad, se realiza electrocardiograma el cual es compatible con síndrome coronario agudo sin elevación del segmento ST. Evolucionó favorablemente con tratamiento según protocolo. El estudio posterior demostró hipersensibilidad a antiinflamatorios no esteroideos y las pruebas de estratificación de isquemia cardiovascular fueron negativas, por lo que se concluyó como un caso de angina alérgica.  Conclusiones: El síndrome de Kounis es una entidad de difícil diagnóstico que requiere un alto índice de sospecha en la valoración de pacientes con dolor torácico en el Departamento de Emergencia.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Kounis syndrome]]></kwd>
<kwd lng="en"><![CDATA[myocardial ischemia]]></kwd>
<kwd lng="en"><![CDATA[drug hypersensitivity]]></kwd>
<kwd lng="en"><![CDATA[ibuprofen]]></kwd>
<kwd lng="es"><![CDATA[Síndrome de Kounis]]></kwd>
<kwd lng="es"><![CDATA[isquemia miocárdica]]></kwd>
<kwd lng="es"><![CDATA[hipersensibilidad a las drogas]]></kwd>
<kwd lng="es"><![CDATA[ibuprofeno]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kounis]]></surname>
<given-names><![CDATA[NG]]></given-names>
</name>
<name>
<surname><![CDATA[Zavras]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Histamine-induced coronary artery spasm the concept of allergic angina]]></article-title>
<source><![CDATA[Br J Clin Pract]]></source>
<year>1991</year>
<volume>45</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>121-8</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rico]]></surname>
<given-names><![CDATA[CP]]></given-names>
</name>
<name>
<surname><![CDATA[Palencia]]></surname>
<given-names><![CDATA[HE]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Kounis syndrome]]></article-title>
<source><![CDATA[Med Intensiva]]></source>
<year>2012</year>
<volume>36</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>358-64</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kounis]]></surname>
<given-names><![CDATA[NG]]></given-names>
</name>
<name>
<surname><![CDATA[Soufras]]></surname>
<given-names><![CDATA[GD]]></given-names>
</name>
<name>
<surname><![CDATA[Hahalis]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anaphylactic Shock Kounis hypersensitivity-associated syndrome seems to be the primary cause]]></article-title>
<source><![CDATA[N Am J Med Sci]]></source>
<year>2013</year>
<volume>5</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>631-6</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Latour-Pérez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Cabello]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical significance of acute coronary syndrome with transient ST-segment elevation]]></article-title>
<source><![CDATA[Med Intensiva]]></source>
<year>2011</year>
<volume>35</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>267-9</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kogias]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Papadakis]]></surname>
<given-names><![CDATA[EX]]></given-names>
</name>
<name>
<surname><![CDATA[Tsatiris]]></surname>
<given-names><![CDATA[CG]]></given-names>
</name>
<name>
<surname><![CDATA[Hahalis]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Kounis]]></surname>
<given-names><![CDATA[GN]]></given-names>
</name>
<name>
<surname><![CDATA[Mazarakis]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Kounis syndrome a manifestation of drug-eluting stent thrombosis associated with allergic reaction to contrast material]]></article-title>
<source><![CDATA[Int J Cardiol]]></source>
<year>2010</year>
<volume>139</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>206-9</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pampín]]></surname>
<given-names><![CDATA[HF]]></given-names>
</name>
<name>
<surname><![CDATA[Jorge]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Prado]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Vázquez]]></surname>
<given-names><![CDATA[VR]]></given-names>
</name>
<name>
<surname><![CDATA[Luis]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute hypersensitivity coronary syndrome Kounis syndrome]]></article-title>
<source><![CDATA[Galicia Clin]]></source>
<year>2014</year>
<volume>751</volume>
<page-range>31-2</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kounis]]></surname>
<given-names><![CDATA[NG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coronary hypersensitivity disorder the Kounis syndrome]]></article-title>
<source><![CDATA[Clin Ther]]></source>
<year>2013</year>
<volume>35</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>563-71</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tavil]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Turfan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Türkoglu]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Abaci]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Kounis syndrome secondary to amoxicillin/clavulanic acid use]]></article-title>
<source><![CDATA[Int J Cardiol]]></source>
<year>2008</year>
<volume>124</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>e4-7</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lombardi]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Pugi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Maggini]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Lenti]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Mugelli]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Cecchi]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Underdiagnosis and pharmacovigilance The case of allergic acute coronary syndrome (Kounis syndrome)]]></article-title>
<source><![CDATA[Int J Cardiol]]></source>
<year>2013</year>
<volume>168</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>5054-5</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cardona Dahl]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Guideline for the management of anaphylaxis]]></article-title>
<collab>Grupo de trabajo de la Guía GALAXIA de actuación en anafilaxia</collab>
<source><![CDATA[Med Clin (Barc)]]></source>
<year>2011</year>
<volume>136</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>349-55</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Narváez]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Poma]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Cobos]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Salazar]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Orbe]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Case report cardiogenic shock secondary to beta-lactam-induced kounis type I syndrome]]></article-title>
<source><![CDATA[REC-online]]></source>
<year>2016</year>
<volume>2</volume>
<page-range>1-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
