Other Important Investigations

Echocardiography

This will be abnormal simply because the heart is transplanted. Common findings include a dilated left atrium, abnormal septal motion and valvular regurgitation. Diastolic dysfunction on tissue Doppler may be suggestive of acute rejection. Graft vasculopathy may cause regional wall motion abnormality.

Endomyocardial biopsy

This is the diagnostic test for graft rejection. Tissue is obtained from the right ventricular (RV) septum using a percutaneous transvenous approach. The test may also show evidence of inflammation, infiltration or ischaemia.

Serological tests

These should be performed for opportunistic infections, such as CMV.