Acute coronary artery dissection after multiple bee stings.

The occurrence of an acute coronary syndrome following an anaphylactic or anaphylactoid reaction is known as Kounis syndrome. Previous reports of Kounis syndrome described an acute coronary syndrome due either to vasospasm or atherosclerotic rupture of a coronary artery in the presence of cutaneous manifestation from the anaphylactic reaction. We report a case of a 33-year-old man who presented with anterior wall acute myocardial infarction immediately after honeybee stings without the presence of cutaneous manifestations other than the bee sting lesions. Emergent coronary arteriography revealed dissection of the proximal left anterior descending artery, which was treated with balloon dilation with an excellent outcome.