Silent acute myocardial infarction following a wasp sting

Hymenoptera sting can lead to an acute myocardial infarction by different pathogenetic mechanisms depending on the presence of preexistent coronary atherosclerosis, the development of shock or the therapeutic use of epinephrine. The case of a 67-year-old man with acute myocardial infarction with ST-segment elevation after a wasp sting treated with fibrinolysis and without significant coronary atherosclerosis is reported. Of particular interest in the present case report is the silent presentation and the absence of any pharmacological interference. It follows that in any case of hymenoptera envenomation a standard ECG is advisable even when a clearly defined allergic reaction is not present.