Investigations
Non-significant coronary lesions on the coronary angiography and absence of regional wall motion abnormalities rule out the ischaemic cardiogenic shock and coronary embolism.
No evidence of hypoxemia on initial blood gases and normal oxygen saturation at the beginning of the case exclude hypoxemic cause.
The sudden presentation after drug administration accompanied by erythema and pruritus led to the diagnosis of anaphylaxis. Coronary angiography showed coronary vasospasm and a tentative diagnosis of Kounis syndrome probably due to amiodarone was made. This was confirmed later through determination of blood tryptase and later with positive allergy tests for amiodarone.