tacrolimus and Aortic-Dissection

We present the case of a 55-year-old lady presenting 5 months after a liver transplant with acute coronary syndrome. She was on maintenance-dose tacrolimus. An angiogram diagnosed a spontaneous coronary artery dissection, which was successfully stented. This is the third case in the literature associating a calcineurin inhibitor with a spontaneous coronary arterial dissection. The detrimental effect of calcineurin inhibitors on vasculature is well recognised. This report highlights their potentially serious side-effects. It should be appreciated that calcineurin inhibitors have the potential to cause or contribute to this rare vascular phenomenon and the diagnosis should therefore be considered in those taking such drugs.

Topics: Aortic Dissection; Calcineurin Inhibitors; Coronary Aneurysm; Coronary Angiography; Diagnosis, Differential; Female; Humans; Immunosuppressive Agents; Middle Aged; Tacrolimus