This report describes a 64-year-old patient who had electrocardiographic evidence of acute cardiac injury but no ensuing myocardial infarction as a complication of systemic anaphylaxis from intravenous cefoxitin. Coronary angiography subsequently demonstrated essentially normal findings except for anomalous origin of the right coronary artery from the left sinus of Valsalva. There is believed to be only one previous report of coronary angiography in a patient who had a myocardial infarction complicating an anaphylactoid reaction to radiographic dye; in that patient, angiography showed coronary atherosclerosis. The possible role of coronary vasospasm in cardiac injury complicating anaphylaxis is discussed.