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Coronary artery vasospasm causing acute myocardial infarction in a heart transplant recipient

John D Bisognano1, Joann Lindenfeld, Elizabeth Hammond

  • 1University of Rochester Medical Center, Rochester, New York, NY, USA.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|March 2, 2005
PubMed

Insights

Cardiac allograft vasculopathy may involve reversible coronary artery vasospasm. This case study highlights abnormal vasoreactivity as an early, potentially reversible stage of cardiac allograft vasculopathy.

Area of Science:

  • Cardiology
  • Transplant Immunology
  • Vascular Biology

Background:

  • Cardiac allograft vasculopathy (CAV) etiology remains unclear, potentially involving endothelial and smooth muscle dysfunction.
  • CAV is a major cause of long-term graft failure after heart transplantation.

Observation:

  • A heart transplant recipient experienced acute myocardial infarction due to coronary artery vasospasm.
  • The patient had a history of severe vascular rejection post-transplant.
  • Chest pain, a rare symptom in denervated hearts, prompted early diagnosis.

Findings:

  • The myocardial infarction was attributed to acute, reversible coronary artery vasospasm.
  • This event occurred months after severe vascular rejection, suggesting a link.

Implications:

  • This case supports the hypothesis that early-stage CAV may present with reversible vasoreactivity abnormalities.
  • Understanding vasoreactivity is crucial for managing and potentially preventing CAV progression.
  • Early detection of vasospasm could offer therapeutic opportunities in heart transplant recipients.

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