Should beta‐blockers be continued as a treatment for myocardial infarction in the case of Kounis syndrome?

A 71‐year‐old male patient reported to our hospital with anaphylactic shock, and the following two issues were focused in this case. First, he was resistant to adrenaline because of taking beta‐blocker, and shock was repeated until glucagon administration was initiated. Second, he developed acute coronary syndrome. Two mechanisms contributing to Kounis syndrome were differentiated: 1) adrenaline induced coronary spasm and platelet activation or 2) a mismatch between oxygen supply and demand due to an allergic reaction. Beta‐blocker therapy was discontinued because his cardiac function was preserved. Secondary preventive beta‐blockers in recovering myocardial infarction with severe anaphylaxis history should be carefully considered.