Post Cardiac Transplant Coronary Artery Disease

From Anvita Health Wiki

Contents 1 Etiology 2 Epidemiology 3 Pathology 4 Clinical-manifestations 5 Radiology 6 Management 7 More General Terms 8 Additional Terms 9 References

Etiology

• endothelial cell injury either humoral or cell-mediated is thought to be etiology

Epidemiology

• primary cause of death >1 year after transplant
• occurs in > 50% of patients 5 years after transplant

Pathology

• differs from conventional CAD
• collateral development around clogged arteries is uncommon, thus infarcts tend to be more extensive
• resembles PTCA restenosis
• intimal thickening secondary to smooth muscle proliferation & collagen accumulation

Clinical-manifestations

• angina pectoris does not occur because of lack of innervation
• heart failure & sudden cardiac death are 2 most common presentations

Radiology

• coronary angiography

• generally shows diffuse tapering vessels rather than discrete focal stenosis

Management

• no effective treatment known

More General Terms

• coronary artery disease (CAD)

Additional Terms

• cardiac transplantation (heart transplant)
• percutaneous transluminal coronary angioplasty (PTCA, percutaneous coronary intervention, PCI)

References

Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998

post cardiac transplant coronary artery disease