Key result
PTCA successfully treats acute MI in a young cardiac transplant recipient presenting with angina.
Why the study?
Acute coronary syndrome is a rare presentation of allograft coronary artery disease in cardiac transplant recipients due to cardiac denervation, but reinnervation and typical angina can occur.
Case Report (n=1)
No
This case highlights that cardiac transplant recipients can present with typical angina during acute myocardial infarction due to reinnervation, and can be successfully managed with percutaneous intervention.
Alerts clinicians to possible typical ACS in reinnervated allografts; leaves open the frequency and impact of reinnervation.
Allograft coronary artery disease (CAD) is the main limiting factor of the long-term survival in cardiac transplant recipients. It is present in approximately 50% of patients at 5 years post-transplant. Allograft CAD might result in congestive heart failure, ventricular arrhythmias and sudden cardiac death. Acute coronary syndrome is a rare presentation of allograft CAD, because symptoms are usually atypical or absent as a result of cardiac denervation. However, it should be reminded that reinnervation of the transplanted heart might occur, and angina pectoris could be felt as a sign of an acute coronary syndrome. We present a 27-year-old female cardiac transplant patient with an acute myocardial infarction, who was successfully treated with percutaneous transluminal coronary angioplasty.
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Bildirici et al. (2009) conducted a case report in Acute myocardial infarction in transplanted heart (n=1). Percutaneous transluminal coronary angioplasty (PTCA) was evaluated on Clinical outcome (successful reperfusion and symptom resolution). A 27-year-old female cardiac transplant recipient presenting with acute myocardial infarction and typical chest pain was successfully treated with percutaneous transluminal coronary angioplasty.
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