Mad-honey sexual activity and acute inferior myocardial infarctions in a married couple.

Mad-honey poisoning can occur after the eating of honey that contains grayanotoxin. Mad honey is intentionally produced from the nectar of Rhododendron ponticum, which grows in Japan, Nepal, Brazil, parts of North America and Europe, and the eastern Black Sea region of Turkey. Low doses of grayanotoxin can cause dizziness, hypotension, and bradycardia, and high doses can cause impaired consciousness, syncope, atrioventricular block, and asystole due to vagal stimulation. Reports of acute coronary syndrome are very rare. Herein, we present the case of a 50-year-old husband and 42-year-old wife who, to improve sexual performance, intentionally ate honey from the Black Sea area of Turkey for 1 week. Within 3 hours of consuming increased amounts of the honey, they presented at our emergency department with acute inferior myocardial infarctions. Coronary angiography revealed normal coronary arteries in both patients. Supportive treatment with atropine rapidly resolved the clinical symptoms and electrocardiographic irregularities. Grayanotoxin-containing rhododendron pollen was detected in the honey.In patients from geographic regions where mad honey can be obtained, mad-honey poisoning should be considered in the differential diagnosis of chest pain, particularly in the presence of unexplained bradyarrhythmia and hypotension. Sexual performance is a chief reason for the purchase of mad honey and self-treatment with it by persons of our patients' ages.