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Reversible Cerebral Vasoconstriction Syndrome After Heart Transplantation: A Case Report
1Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan.
Transplantation Proceedings
|December 5, 2017
Summary
Reversible cerebral vasoconstriction syndrome (RCVS) can occur after heart transplants. Tacrolimus, an immunosuppressant, may trigger RCVS, necessitating prompt diagnosis and treatment to prevent neurological damage.
Area of Science:
- Neurology
- Cardiology
- Pharmacology
Background:
- Reversible cerebral vasoconstriction syndrome (RCVS) is a transient cerebrovascular disorder.
- RCVS is potentially triggered by immunosuppressive agents.
Observation:
- A heart transplant recipient developed RCVS post-surgery.
- The patient experienced severe headaches and neurological deficits.
- Brain imaging revealed cerebral infarction and diffuse vasoconstriction.
Findings:
- Tacrolimus, an immunosuppressant, was identified as the likely cause of RCVS.
- Discontinuation of tacrolimus and initiation of alternative treatments led to symptom improvement.
- Cerebrovascular constrictions resolved on follow-up MRI.
Implications:
- RCVS must be considered in heart transplant recipients presenting with headaches.
- Early recognition and intervention are crucial to prevent permanent neurological deficits.
- Immunosuppressive therapy requires careful monitoring for potential cerebrovascular complications.
