Following a cardiac transplant, some individuals will develop a type of chronic rejection called coronary artery disease. This is different from the narrowed arteries often seen in individuals who have not had heart transplants. It can happen at any time after a heart transplant, but usually is seen a few years after the surgery. Another complication is called cardiac allograft vasculopathy (CAV). CAV makes the walls of the heart's arteries thick and hard making blood circulation more difficult. It can result in a heart attack, failure of the heart, cardiac death, or abnormal heart rhythms.
Edwin Yih-Jen. Kok, MD
- internal medicine
Location and Office HoursSouthern California Heart Center
506 W Valley
San Gabriel, CA 91776
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- Alhambra Hospital Medical Center
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- San Gabriel Valley Medical Center
- Can I get coronary artery disease after a cardiac transplant?
How does heart valve disease change my lifestyle?
Heart valve disease is a lifelong condition. However, many people with the condition don't have any symptoms until they're middle-aged or older. Over time, heart valve disease may worsen and can cause heart failure or other life-threatening conditions.
Eventually, you may need your faulty heart valve(s) repaired or replaced. After repair or replacement, you will still need certain medicines and regular checkups with your doctor.
Ongoing Health Care Needs
- See your doctor regularly for checkups and for echocardiography or other tests. This will allow your doctor to check the progress of your heart valve disease. Ask your doctor what physical activities are appropriate for you.
- Call your doctor if your heart valve disease symptoms worsen or you develop new symptoms.
- Call your doctor if you develop symptoms of endocarditis. Symptoms of this heart infection include fever, chills, muscle aches, night sweats, difficulty breathing, fatigue (tiredness), and weakness, red spots on the palms and soles, and swelling of the feet, legs, and belly.
- Let your doctors and dentists know if you have a man-made valve or if you've had endocarditis before. They may give you antibiotics before medical or dental procedures (such as surgery or dental cleanings) that could allow bacteria to enter your bloodstream. Talk to your doctor about whether you need to take antibiotics before such procedures.
- Take all your prescribed medicines.
Pregnancy and heart valve disease
Mild to moderate heart valve disease during pregnancy usually can be managed with medicines or bed rest without posing heightened risks to the mother or fetus.
Most heart valve conditions can be treated with medicines that are safe to take during pregnancy. Your doctor can advise you on which medicines are safe for you.
Severe heart valve disease can make pregnancy or labor and delivery riskier. If you have severe heart valve disease and/or its symptoms, consider having your heart valves repaired or replaced before getting pregnant. Such repair or replacement also can be done during pregnancy, if needed. But this surgery poses danger to both the mother and fetus.
This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.
What are the symptoms of adult congenital heart disease (ACHD)?
Emile Bacha, MD, Cardiothoracic Surgery, answered on behalf of Columbia University Department of Surgery
Since consequences of early heart repairs often develop slowly and without symptoms, people are often unaware that a problem may exist. Anyone who has had open-heart surgery as a child should be evaluated by a specialist in adult congenital heart disease (ACHD) and at the very minimum have an annual echocardiogram.
Thousands of people have had open-heart surgery and think they are fine, but they are typically sedentary. They often say, “I feel fine, but I don't exercise because I get short of breath or cramps.” So they feel okay, but they are living sedentary lives. When we see such people, we often find they have a leaky heart valve, or a hole in the heart that was left behind. Once that problem is corrected, people are thrilled -- they can go up stairs without becoming winded, and they stop feeling short of breath. Yet until they come in for evaluation, they just think it is normal to feel that way.
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