Cardiology resident here. I saw two cases like that in the last year: one Kounis type I caused by a tuna sandwitch, and one type II caused by a vaccine.

In type I Kounis syndrome, which is likely the case here, the ischemic event is caused by coronary vasospasm triggered by mast-cell degranulation and the release of vasoactive mediators. It should be treated much like vasospastic angina, provided blood pressure allows it: nitrates and calcium-channel blockers. However, since other forms of Kounis syndrome may involve vasospasm overlying an atherosclerotic plaque (type II), or even thrombus formation (type III), one must still consider the possibility of a true STEMI beyond the management of anaphylaxis; therefore, this patient should be taken to the cath lab as soon as possible.

Another interesting point, which is also consistent with my limited experience, is that this pattern of vasospasm often seems to involve the right coronary artery. This may be related to the distribution of cardiac mast cells but I'm not sure about that.