Coronary artery vasospasm causing acute myocardial infarction in a heart transplant recipient.
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.
Bisognano
John D
JD
University of Rochester Medical Center, Rochester, New York, NY, USA.
Lindenfeld
Joann
J
Hammond
Elizabeth
E
Zisman
Lawrence S
LS
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
D014665:Vasodilator Agents; D005996:Nitroglycerin