| Summary points: | A 53-year-old male, with a history of angina treated by percutaneous coronary intervention without allergic reaction to contrast and coronary bypass surgery, presents with epigastralgia and tarry stool. During an enhanced computed tomography, and again during a coronary angiography, he became hypotensive and had chest pain; images provided. The authors discuss alternative coronary interventional procedures without the use of iodinated contrast media. |