BACKGROUND Coronary artery spasm (CAS) is an underdiagnosed disease especially in heart transplant patients, and in those patients the etiology and pathophysiology remain largely unknown, although it has been associated with cardiac allograft vasculopathy or graft rejection. CASE PRESENTATION We report the case of a heart-transplant patient whose cardiac graft experienced two coronary vasospasms: the first before transplantation, and the other at one-month of a postoperative course complicated by primary graft failure. CONCLUSION Our case illustrates that a transplanted heart predisposed with coronary vasospasm may suffer from early relapse in the recipient despite of complete post-surgical autonomic denervation. Exacerbated endothelial dysfunction of the donor heart after transplant, with the addition of systemic factors in the recipient may be involved in the genesis of this puzzling phenomenon.

中文翻译：

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病例报告-移植心脏中的冠状动脉痉挛：令人困惑的现象。

背景技术冠状动脉痉挛（CAS）是一种未被充分诊断的疾病，特别是在心脏移植患者中，尽管与心脏同种异体移植血管病或移植排斥相关，但在这些患者中病因学和病理生理学仍然未知。病例介绍我们报道了一例心脏移植患者，该患者的心脏移植物经历了两次冠状动脉痉挛：第一个在移植前，另一个在术后一个月并发原发性移植物衰竭的情况下发生。结论我们的病例说明，尽管手术后自主神经完全消失，但易患冠状动脉痉挛的移植心脏可能会在接受者中早期复发。移植后供体心脏的内皮功能异常加重，