post cardiac transplant coronary artery disease

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; coronary atherosclerosis (CAD)

Additional terms

• cardiac transplantation; heart transplant