A patient is being evaluated for rejection after a heart transplant. What will this assessment include?
1. Repeated heart biopsies to assess for myocyte damage or necrosis
2. Signs of chest pain or pain, numbness, or tingling in the left arm
3. 2D echo to assess heart function and left ventricular ejection fraction
4. Signs of heart failure such as sudden weight gain, shortness of breath, and rales on auscultation of the lungs
1
Rationale 1: Rejection is diagnosed via endomyocardial biopsies that are performed at regular intervals post-transplant. The post–heart transplant patient in early rejection often shows no signs. Therefore, biopsies are important to diagnose early rejection.
Rationale 2: This is not an assessment for transplant rejection.
Rationale 3: This is not an assessment for transplant rejection.
Rationale 4: Late signs of heart rejection include signs of heart failure.
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