Acute myocardial injury following penicillin-associated anaphylactic reaction in a patient with normal coronary arteries.

Cardiac involvement is uncommon and important clinical finding during an anaphylactic reaction, and it occurs primarily in subjects with underlying ischemic heart disease. The main mechanism proposed is the vasospasm of coronary arteries. We report a rare case of acute ST-elevation myocardial injury after penicillin-induced anaphylaxis in a patient with normal coronary arteries. Physicians should be alert for such a serious complication in order to diagnose it early and treat properly. We suggest that cardiac monitoring and appropriate therapy should be available for patients with severe allergic reactions especially during parenteral administration of epinephrine.