Acute myocardial infarction after cardiac transplantation

Authors: Gafurov F.S., Markitan S.V., Zakharova A.B., Khaydarov G.A., Madaminov I.Ya., Stepanyan A.V., Mukanova M.B.

Company: 1 Egor'evsk Central Regional Hospital, Egor'evsk, Moscow Region, Russian Federation
2 Moscow Regional Ambulance Station, Central Branch, Balashikha, Moscow region, Russian Federation

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Type:  Case reports


DOI: https://doi.org/10.24022/1997-3187-2021-15-2-263-267

For citation: Gafurov F.S., Markitan S.V., Zakharova A.B., Khaydarov G.A., Madaminov I.Ya., Stepanyan A.V., Mukanova M.B. Acute myocardial infarction after cardiac transplantation. Creative Cardiology. 2021; 15 (2): 263–7 (in Russ.). DOI: 10.24022/1997-3187-2021-15-2-263-267

Received / Accepted:  06.06.2020 / 24.06.2020

Keywords: cardiac transplantation acute myocardial infarction cardiac allograft vasculopathy

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Abstract

Cardiac allograft vasculopathy is a major factor limiting heart recipient’s long-term survival. This process is an accelerated form of coronary artery disease, which is characterized by concentric fibrous intimal hyperplasia along the length of coronary vessels. Both immunologic and nonimmunologic risk factors contribute to the development of this vasculopathy by causing endothelial dysfunction. Global treatment of cardiac allograft vasculopathy is limited, usually involves repeat transplantation and drug prevention of immunologic and nonimmunologic risk factors. As an emergency measure, cases of percutaneous coronary interventions of the transplant are described. This complication occurs in approximately 50% of patients by 5 years after cardiac transplantation. Due to the cardiac denervation, these patients are characterized by development of painless form of acute myocardial infarction. This report presents a clinical case of a painless ST-elevated acute coronary syndrome in 44 years old patient at 3 years after cardiac transplantation. The correct interpretation of clinical status of the patient made it possible to refer the patient to an invasive study in a timely manner, identify critical stenosis in left circumflex artery, and perform successful percutaneous coronary intervention.

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About Authors

  • Furkatzhon S. Gafurov, Сand. Med. Sci., Head of Department; ORCID
  • Sergey V. Markitan, Chief Physician; ORCID
  • Anna B. Zakharova, Deputy Chief Physician; ORCID
  • Golib A. Khaydarov, Anesthesiologist-Intensivist; ORCID
  • Ikromidin Ya. Madaminov, Endovascular Surgeon; ORCID
  • Armen V. Stepanyan, Endovascular Surgeon; ORCID
  • Maruar B. Mukanova, Head of Ambulance Substation; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery