Spontaneous Coronary Artery Dissection in an Orthotopic Heart Transplant Recipient
Josephine Warren1, Caitlin Cheshire1, Sarah Gutman1,2
1Department of Cardiology Alfred Hospital, Melbourne, Australia.
JACC. Case Reports
|August 8, 2022
Insights
We report a rare case of acute myocardial infarction caused by spontaneous coronary artery dissection just two weeks after a heart transplant. This highlights a potential complication following orthotopic heart transplantation.
Area of Science:
- Cardiology
- Transplantation Medicine
- Cardiovascular Surgery
Background:
- Orthotopic heart transplantation is a life-saving procedure for end-stage heart failure.
- Spontaneous coronary artery dissection (SCAD) is a rare but serious condition affecting coronary arteries.
- Post-transplant complications require vigilant monitoring and prompt diagnosis.
Observation:
- A patient developed acute myocardial infarction (heart attack) symptoms.
- The infarction was found to be secondary to spontaneous coronary artery dissection.
- This event occurred two weeks after undergoing an orthotopic heart transplantation.
Findings:
- The case demonstrates a novel association between SCAD and recent heart transplantation.
- Early diagnosis of SCAD in post-transplant patients is crucial for management.
- Coronary angiography confirmed SCAD as the cause of myocardial infarction.
Implications:
- This case underscores the importance of considering SCAD in heart transplant recipients presenting with ischemic symptoms.
- Further research may elucidate the specific mechanisms linking transplantation and SCAD.
- Timely recognition and intervention can improve outcomes for these complex patients.
Abstract:
We present the case of acute myocardial infarction secondary to spontaneous coronary artery dissection in a patient 2 weeks post orthotopic heart transplantation. (Level of Difficulty: Advanced.).
