Transplant Vasculopathy: Evaluation With Multi-Detector Computed Tomography

A 43-year-old man was admitted with progressive fatigue, shortness of breath, and orthopnea. He received an orthotopic heart transplant 13 years ago, which was complicated by multiple episodes of rejection. His last catheterization 2 years before presentation demonstrated moderate transplant vasculopathy. More recently, a nuclear perfusion scan showed a myocardial scar in the mid to basal anterior and anterolateral walls, but no reversible stress-induced ischemia. On admission, the ECG showed normal …