Recurrent Lethal Allergic Coronary Vasospasm

Acute coronary syndrome induced by a hypersensitivity reaction to allergen exposure is known as Kounis syndrome.1 We present a case of recurrent Kounis syndrome in a patient with coronary artery disease who developed coronary vasospasm following administration of perflutren lipid microsphere (Definity®) echocardiographic contrast, followed by lethal recurrent vasospasm after administration of iodixonal (Visipaque®) angiographic contrast, despite administration of standard contrast allergy prophylaxis.