Sharp chest pains occurring during right ventricular biopsy in a patient 9 years after cardiac transplant

The goal of this case report is to discuss the possible cause of sharp chest pain occurring during myocardial biopsy in post cardiac transplant patients.

A 21-year-old man who had undergone a heart transplant 9 years earlier presented with fatigue. He underwent right ventricular biopsy for further evaluation.

During each of his 3 biopsies, he complained of severe sharp chest pain. His chest pain occurred only during biopsy and not when he had premature ventricular contraction during catheter manipulation.

The occurrence of sharp chest pain during myocardial biopsy in this patient may suggest somatic innervation of the donor heart.