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Bernard H. Booth, MD; Roy Patterson, MD

JAMA. 1970;211(4):627-631.

Abstract
Twenty-three instances of anaphylaxis in humans were observed. Electrocardiograms were obtained within 24 hours of the acute episode in 14 of the 23 patients. Six patients had abnormal ECGs. The abnormal findings were variable and consisted of flattening of the T waves, inversion of the T waves, ST segment elevation or depression, a nodal rhythm, and atrial fibrillation. The electrocardiographic changes are considered to be specifically related to the anaphylaxis for several reasons. In at least three of the patients, agents used for treatment of the anaphylaxis could not be implicated. No evidence of preexisting heart disease was apparent in any patient. The electrocardiographic changes appear to parallel similar changes that occur during experimentally induced anaphylaxis in subhuman primates. The exact mechanism responsible for production of the electrocardiographic changes is unknown. Multiple factors could be involved.

Author Affiliations
From the Section of Allergy-Immunology, Department of Medicine, Northwestern University Medical School, Chicago.

Footnotes
Reprint requests to 33 E Chicago Ave, Chicago 60611 (Dr. Patterson).

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