[Coronary artery spasm with anaphylactoid shock due to low-molecular dextran].

An anaphylactoid shock with S-T segment elevation in leads II and III and total AV block developed in an 81-year-old man, soon after starting an infusion of about 10 ml of low-molecular dextran and just before a planned balloon dilatation of the anterior descending branch. The shock state was caused by an angiographically demonstrated spasm of the, previously normal, right coronary artery. Intracoronary injection of 0.3 mg nitroglycerin resolved the spasm within two minutes and the patient's general condition returned to normal.