Myocardial infarction following a bee sting. Case report and review of the literature

The authors report a case of limited inferior myocardial infarction in a young man following a bee sting. Coronary angiography, performed following the acute phase, showed angiographically healthy coronary arteries and minimal sequelae of myocardial necrosis in the inferior territory. The pathogenic role of the bee sting in myocardial necrosis was suggested by the timing of the events. The probable mechanism responsible for this myocardial infarction was severe coronary arterial spasm (partly mediated by psychological stress related to the intensity of the anaphylactic reaction) with secondary in situ thrombosis probably facilitated by cardiovascular collapse. The role of anaphylaxis, generating acute coronary insufficiency, is discussed in the light of this clinical case.