Atheroembolism in an endomyocardial biopsy from a cardiac transplant recipient after coronary angioplasty.

A case of a coronary atheroembolism after coronary angioplasty was detected by routine myocardial biopsy six years after cardiac transplant. The patient had had three balloon angioplasties within a five week interval for symptomatic accelerated coronary artery disease. Histological examination clearly identified atheromatous debris in a small intramyocardial artery with a secondary inflammatory response. This complication of angioplasty has been identified at necropsy in association with new myocardial infarction. It is unusual to identify this complication in a survivor, and in a case in which there was no clinical evidence of myocardial infarction. Myocardial biopsy samples a relatively small amount of myocardium, and this case suggests that coronary atheroembolism may not be an uncommon complication of angioplasty.