Acute coronary syndrome in the presence of an allergic reaction is known as Kounis syndrome, which is an underdiagnosed disorder and has nuances regarding management. We present a patient brought into the hospital as a STEMI alert in the setting of an allergic reaction triggered by food. During the course of the emergency department stay, the patient went into anaphylactic shock requiring epinephrine and adjunctive therapies, with improvement in allergic symptoms and resolution of ST elevations. Inflammatory mediators released during an allergic reaction can lead to coronary vasospasm, known as Kounis syndrome, which has implications regarding management of a typical allergic reaction and acute coronary syndrome.