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Mohammed Shakawat Alam, Arvind Sahadev Singh, Sreeja Pavithran, Vijayakumar Subban, Ajit Mullasari, Kothandam Sivakumar
Department of Cardiology, Madras Medical Mission, Chennai, Tamil Nadu, India
Correspondence Address:
Kothandam Sivakumar
Senior Consultant Cardiologist, Madras Medical Mission, Chennai - 600 037, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/apc.APC_69_19
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.
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