摘要Background:Diagnosis of Kounis syndrome,an acute coronary syndrome associated with anaphylactic reactions,is challenging owing to the overlapping symptoms of myocardial ischemia.Takotsubo syndrome(TTS),characterized by stress-induced cardiomyopathy,may share pathophysiological mechanisms with Kounis syndrome and potentially coexist in the same patient.Case Presentation:We present a case of a 63-year-old patient who developed an allergic reaction to contrast medium administration,leading to dyspnea and chest pain.Electrocardiography revealed a new-onset left bundle-branch block,and echocardiography indicated wall motion abnormalities with apical ballooning,suggestive of TTS.Coronary angiography displayed a chronic total occlusion of the right coronary artery.Laboratory tests revealed elevated inflammatory markers,supporting the diagnosis of Kounis syndrome and TTS.Conclusion:This case highlights the challenges of diagnosing and managing type Ⅱ Kounis syndrome associated with concurrent TTS.This underscores the need for tailored therapeutic interventions and comprehensive guidelines to address these complex conditions effectively.