Allergic Acute Coronary Syndrome; A Fatal Presentation in the Emergency Department

Allergic angina is not a rare disease, but it should be recognized at the earliest. We are reporting two cases of anaphylaxis, one with a history of unknown insect bite and the other due to intravenous (IV) contrast, leading to reversible myocardial ischemia, which we managed in our Emergency Department. These two patients clinically improved, and their ST-segment elevation on electrocardiogram (ECG) disappeared after intramuscular adrenaline. Allergic angina is an acute presentation in which anaphylaxis, or allergic insult, causes coronary spasm, which leads to angina. Early diagnosis and management initiation can minimize mortality and morbidity