Acute ST-Segment Elevation Due to Coronary Vasospasm After Cefuroxime Induced Anaphylactic Shock

  • Nikolaos Laschos NIMTS Hospital
  • Stavros Tzerefos Tzaneio Hospital
  • Andreas Katsaros Ippokrateio Hospital
  • Dimitrios Chrissos General Hospital of Tripolis
Keywords: acute coronary syndromes, allergic reaction, Kunis syndrome


A  41-year-old patient presented to the emergency room after intake of cefuroxime 500 mg. He had dyspnea and hypotension and  the ECG showed ST elevation in leads II, III, aVF, V2-V6. He was successfully managed with oxygen, intravenous corticoids, antihistamines and epinephrine. This constellation of presenting symptoms and signs was attributed to a manifestation of Kounis syndrome (allergic angina). The connection between acute coronary syndromes and anaphylaxis seems to be strong. The same mediators released during acute allergic reactions are increased in blood or urine of patients suffering from acute coronary syndromes of non allergic etiology.