Pitfalls

Heart transplant patients may have a life threatening infection without being overtly septic
Symptoms of graft rejection may be vague and non-specific – index of suspicion needs to be high
Because of denervation, ischaemia of the transplanted heart is seldom associated with pain
Conventional management strategies for ischaemic events are often ineffective
Recipient P waves may lead to inappropriate diagnosis of AV block
Atropine is ineffective for bradyarrhythmias because the heart is denervated
Beta blockers must be used with caution because transplant patients rely on circulating catecholamines to increase their cardiac output.