Angina pectoris in the heart transplant recipient: Evidence of reinnervation

Heart transplantation involves the removal of a sick heart together with it s innervation and replacement with a donor heart isolated from the control of the autonomous nervous system of the recipient, therefore being, functio nally dennervated. Dennervation conditions several alterations in cardiac p hysiology, shuch as the inability to experience pain during myocardial isch emia, so that theoretically these patients cannot present angina pectoris. However, several reports have shown evidence of reinnervation with isolated cases of transplanted patients with angina pectoris having been reported. We describe the case of a transplanted patient who showed typical effort an gina, vascular disease of the graft and data of sympathetic reinnervation d emonstrated by cardiac gammagraphy with metayodo-benzilguanidina-1-123.