Rapid Resolution of Coronary Artery Spasm Complicated by Acute Systolic Heart Failure with Antirejection Therapy in Acute Orthotopic Heart Transplant Rejection

Abstract

We report a case of rapid resolution of Coronary Artery Spasm (CAS) and improvement of systolic heart failure by antirejection therapy with methylprednisolone in the setting of acute Orthotopic Heart Transplant (OHT) rejection. The proposed mechanism of action is reduced microvascular inflammation from steroid therapy resulting in enhanced vasomotor response, resolution of coronary artery spasm, and improved hemodynamic. The case report has treatment implications for patients in acute OHT rejection with coronary artery spasm. Antirejection therapy with steroid may be helpful in treating life threatening cardiac conditions in patients with acute OHT rejection and coronary artery spasm.