A case of cardiac stress following a grade 4 perioperative anaphylaxis was identified. We speculate that this may be a case of Kounis or adrenaline, takotsubo, anaphylaxis and Kounis (ATAK) complex. This is the first such case reported from the UK. We propose performing routine cardiac investigations in patients with grade 4 anaphylaxis or chest pain following anaphylaxis to evaluate any similar future presentations.
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