BMJ case reports
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Anaphylactic reaction to contrast media during selective coronary angiography is a rare occurrence. It can be occasionally resistant to medical treatment leading to cardiovascular collapse and death. ⋯ We report a case of a severe contrast media-induced anaphylactic shock which failed to respond to the supportive medical management and the timely insertion of IABP for further circulatory support that prevented death in a patient who had an elective diagnostic coronary angiography. The clinical diagnosis of anaphylaxis was challenging at the onset of shock as the typical rash developed after a few minutes.