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.