Myocardial infarction in an adult with cystic fibrosis and heart and lung transplant

Abstract

We present a case of myocardial infarction in a 19 year old female with cystic fibrosis who had a heart and lung transplant performed at the age of four years old. She presented atypically with a one day history of severe, intermittent, central, sharp chest pain, radiating to her back and down her left arm. A coronary angiogram showed proximal stenosis of the left anterior descending artery and right coronary artery. She was treated with percutaneous coronary intervention, involving drug eluting stents to the left anterior descending artery (LAD) and the right coronary artery (RCA). In this study we discuss the pathophysiology, investigations and treatment of cardiac transplant vasculopathy. Although complete reversal of LAD and RCA stenosis was achieved, routine follow-up with coronary angiography and careful control of cardiac risk factors will be important to identify and reduce future restenosis and adverse cardiac events.

Technological advances shed light on left ventricular cardiac disturbances in cystic fibrosis

“…Abnormalities in glucose metabolism, hypertriglyceridemia, and other dyslipidemias have also been reported in the aging CF population [125][126][127][128][129][130]. Within the last few years, case reports have described CF patients with cardiac complications including symptomatic myocardial infarctions, suggesting that pulmonary complications may not be the only major concern for this patient population anymore [131,132]. Additionally, some CF patients experience significant desaturations and ventricular arrhythmias when they exercise, even though exercise is one of the recommended therapies for CF; also, with improved lung function, more patients are engaging in strenuous exercise [133].…”