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.