Coronary artery involvement in chronic graft-versus-host disease presenting as sudden cardiac arrest.

Abstract:

:Graft-versus-host disease (GVHD) is related to considerable morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Cardiac complications associated with GVHD are uncommon, and coronary artery involvement is even more unusual. We report on a male pediatric patient with chronic GVHD who developed a fatal ventricular arrhythmia caused by coronary artery obstruction after HSCT. At 30 months after HSCT, he suddenly collapsed with ventricular fibrillation. After resuscitation, electrocardiography showed abnormal q-wave and ST changes in the inferior leads, suggesting a coronary event. Coronary angiography revealed complete obstruction of the proximal left anterior descending artery, subtotal obstruction of the mid left circumflex artery, and mild narrowing at the right coronary artery. This boy had none of the risk factors for coronary artery disease, and the only possible explanation for the cardiac event is GVHD. Coronary artery disease only rarely occurs as a cardiac event in children. However, coronary artery involvement should be recognized as one of the important manifestations of chronic GVHD in children.

journal_name

Pediatr Transplant

authors

Kim DH,You JJ,Im HJ,Ko JK

doi

10.1111/petr.13474

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

e13474

issue

5

eissn

1397-3142

issn

1399-3046

journal_volume

23

pub_type

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