We read with the great interest the excellent and concise review of Filippo Fassio et al. [1] focused on Kounis syndrome and its treatment. Since the description of this syndrome has paved the possibility for prevention of the progression of coronary plaques to unstable lesions with inhibition of mast cell activation, that has been already achieved experimentally [2], we believe that the following observations and additions on its pathophysiology and management would be of value.
