title: Coronary artery vasospasm causing acute myocardial infarction in a heart transplant recipient.
abstract: The etiology of cardiac allograft vasculopathy is not known, but may be preceded by both endothelial cell and smooth muscle dysfunction of the epicardial coronary arteries. We here report a case of acute, reversible coronary artery vasospasm which caused a myocardial infarction in a cardiac transplant recipient. The patient had a complex post-transplant course, including an episode of severe vascular rejection several months before this presentation. Interestingly, the event was captured in its early stages because the patient presented with chest pain: a rare event because of the denervation of the transplanted heart. Our ability to document the etiology of this patient's myocardial infarction supports the concept that cardiac allograft vasculopathy is a progressive disease that, in its early stages, may include a reversible component of abnormal vasoreactivity.
authors.affiliation: University of Rochester Medical Center, Rochester, New York, NY, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Bisognano
authors.forename: Joann
authors.initials: J
authors.lastname: Lindenfeld
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hammond
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Zisman
mesh_terms: D000208:Acute Disease; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D018450:Disease Progression; D006084:Graft Rejection / Q000453:epidemiology; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D005996:Nitroglycerin / Q000627:therapeutic use; D014184:Transplantation, Homologous; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin