The authors report a patient with a history of angina pectoris who developed anaphylactic shock that was complicated by a heart failure due to focal heart ischaemia. Early coronary angiography confirmed the diagnosis of localised coronary hypoperfusion. Intra aortic balloon counter pulsation succeeded in the restoration of coronary blood flow and haemodynamic stability. The authors discuss the opportunity of such treatment when a focal coronary hypoperfusion is diagnosed.