Type II Kounis syndrome diagnosed by optical coherence tomography and coronary angioscopy.

Kounis syndrome (KS), an allergen-induced coronary artery disorder, is classified as type I, causing vasospastic allergic angina; type II, causing allergic acute coronary syndrome (ACS) contrib-uted to vulnerable plaque; and type III, causing coronary artery stent thrombosis. Herein, we report the first documented type II KS case diag - nosed using optical coherence tomography (OCT) and coronary angioscopy (CAS). An 80-year-old man underwent resection for bladder cancer. One gram of cefazolin was administered at the beginning of surgery, and rocuronium and propofol were administered before intubation. A few minutes later, the patient’s blood pressure dropped suddenly from 120/80 mmHg to 70/40 mmHg, and