Kounis Syndrome is the development of acute coronary syndrome (ACS) because of allergic reactions; allergens, such as foods, insect venom, iodine contrast agent or drugs can cause this syndrome. Hirudotherapy (leech therapy) is increasingly used as a useful therapeutic option in a variety of medical and surgical procedures, and potential complications related to this therapy include Aeromonas species infections, bleeding, anemia and allergic reactions. Here, we present a patient diagnosed as Type 1 Kounis Syndrome after using hirudotherapy for her knee aches. 41-year-old woman admitted to emergency department with sudden onset of face edema, shortness of breath and chest pain complaints and diagnosed as an allergic reaction and anaphylaxis due to leech therapy. Kounis Syndrome should be considered in acute coronary syndrome patients who were admitted to emergency department with anaphylaxis clinic.

Carbon monoxide intoxication is one of the most common types of poisoning in the world. Cardiac manifestations after exposure to carbon monoxide including myocardial ischemia, heart failure and arrhythmias have been reported. A 17-year-old woman was admitted to the emergency service with the complaints of palpitation, headache and nausea. Electrocardiogram revealed supraventricular tachycardia. The arterial blood gas analysis was normal. Her carboxyhemoglobin level was 19% and oxygen treatment was started promptly. Echocardiographic examination demonstrated normal cardiac function. To the best of our knowledge, this case report is the first carbon monoxide intoxication case in the literature presenting with supraventricular tachycardia attack.