Mohammed Shakawat Alam, Arvind Sahadev Singh, Sreeja Pavithran, Vijayakumar Subban, Ajit Mullasari, Kothandam Sivakumar
Department of Cardiology, Madras Medical Mission, Chennai, Tamil Nadu, India
Coronary allograft vasculopathy fails to give a warning anginal pain due to denervation and often presents with acute coronary syndrome, ventricular dysfunction, or sudden cardiac death. Early diagnosis in a pediatric patient is difficult as it involves invasive coronary angiography or advanced imaging such as intravascular ultrasound or optical coherence tomography. A 12-year-old boy developed acute coronary syndrome, elevated troponins, and right bundle branch block, 5 years after cardiac transplantation and was treated with culprit-vessel angioplasty with a drug-eluting stent. Advanced imaging showed the involvement of nonculprit vessels too. In a detailed literature search, we failed to identify a similar clinical presentation and management in the subcontinent, hence our interest in publishing this report for educational value. Issues in diagnosis, management, prognosis, and prevention are discussed.
Senior Consultant Cardiologist, Madras Medical Mission, Chennai - 600 037, Tamil Nadu
Source of Support: None, Conflict of Interest: None
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