Cardiac allograft vasculopathy history and symptoms

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Cardiac allograft vasculopathy Microchapters


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Differentiating Cardiac allograft vasculopathy from other Diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]; Raviteja Guddeti, M.B.B.S. [3]


Patients with cardiac allograft vasculopathy (CAV) seldom present with typical angina symptoms due to cardiac denervation at the time of heart transplantation.

History and Symptoms

As mentioned above, patients with cardiac transplants do not typically present with anginal symptoms. About 10-30% of patients regain some renervation to the heart. Hence, they typically present late with the following manifestations.

  1. Graft failure
  2. Arrhythmias
  3. Silent myocardial infarction: Due to denervation at the time of surgery patients with CAV rarely present with typical angina symptoms, especially in the initial years of transplantation.[1] However, studies have demonstrated that re-innervation does occur late after heart transplantation.[2]
  4. Sudden death

The current practice is to routinely screen cardiac allograft recipients using conventional angiography or intravascular ultrasound (IVUS) as discussed in subsequent sections.


  1. Di Cori A, Petronio AS, Gemignani C, Zucchelli G, Di Bello V, Mariani M (2005). "Symptomatic acute myocardial infarction in a cardiac transplant recipient successfully treated with primary coronary angioplasty: evidence of prognostic importance of chest pain after cardiac transplantation". J Heart Lung Transplant. 24 (8): 1146–9. doi:10.1016/j.healun.2004.07.003. PMID 16102462.
  2. Gallego-Page JC, Segovia J, Alonso-Pulpón L, Alonso-Rodríguez M, Salas C, Ortíz-Berrocal J (2004). "Re-innervation after heart transplantation: a multidisciplinary study". J Heart Lung Transplant. 23 (6): 674–82. PMID 15366426.

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