Perioperative Anaphylaxis Complicated by Myocardial Infarction: Intraoperative Management

Document Type

Conference Proceeding

Publication Date

10-17-2026

Abstract

We present a 63‑year‑old male with a history of amoxicillin allergy undergoing elective CABG who developed catastrophic cardiovascular collapse immediately after cefazolin administration. Abrupt bronchospasm, hypotension, and pulseless electrical activity were followed by refractory ventricular fibrillation, necessitating emergent cardiopulmonary bypass and on‑pump revascularization. The clinical presentation was most consistent with an anaphylaxis‑associated myocardial infarction (Kounis syndrome), illustrating the lethal intersection of perioperative anaphylaxis, coronary ischemia, and malignant arrhythmias. This case underscores the diagnostic and therapeutic complexity of managing anaphylactic myocardial infarction, where epinephrine use, mechanical circulatory support, and urgent revascularization must be balanced against ongoing inflammatory and ischemic injury.

Comments

American Society of Anesthesiologists, The Anesthesiology Meeting, October 16-20, 2026, San Diego, CA

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