Arq. Bras. Cardiol. 2022; 118(5): 996-999
An Unusual Manifestation of Rejection
Carlos Xavier Correia de Resende
, Pedro Grilo Diogo
, Sandra Amorim
, Gonçalo Pestana
, José Pinheiro Torres, Filipe Macedo
Introduction
Orthotopic heart transplantation is the current treatment of choice for selected patients with end-stage heart failure. With the improvement of surgical techniques and the efficiency of new immunosuppressive treatments, short-term survival has markedly improved throughout the years. However, these patients still suffer from important comorbidities caused by chronic transplant complications such as rejection, coronary allograft vasculopathy (CAV) and malignancy. Rhythm disorders are common in heart transplant patients and in some circumstances, they can be the first clinical manifestation of rejection. Coronary vasospasm has been recently associated with acute rejection and CAV, but the mechanisms underlying this phenomenon are still speculative.
We present a clinical case of acute heart transplant rejection, manifested by coronary vasospasm and advanced rhythm disorder.
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