Definition
Cardiac allograft vasculopathy is an accelerated type of coronary artery disease in people who have had a heart transplantation. Signs and symptoms
Unlike the chest tightness of angina in those who have not had a heart transplant, people with CAV typically do not experience chest pain because the donor heart has lost its nerve supply. A few regain nerves some years later and may develop unusual chest pain. People with CAV may present with a broad spectrum of symptoms including tiredness, nausea, or abdominal discomfort or may have no symptoms at all. Shortness of breath and arrythmias may also occur. Risk factors
Similar to coronary artery disease in those who have not had a heart transplant, risk factors to CAV include high blood pressure, high cholesterol, and diabetes mellitus. Other risk factors exclusive to CAV include older donors, cytomegalovirus infection and circulating antibodies after heart transplantation. The mechanism of donor brain death, particularly explosive brain death in the donor has been shown to be a significant factor. It is probably the combination of injuries to the allograft that determine the risk of developing CAV. Mechanism
Immunological (innate and adaptive) and nonimmunological factors contribute to the complex pathogenesis of CAV.In those nontransplanted people who develop coronary artery disease due to atherosclerosis, progression of disease is slow, histological changes are confined mainly to the main coronary arteries and arterial dilatation is observed as a form of compensatory remodelling.
Being unemployed can also reduce the life expectancy of workers by about seven years.High unemployment can encourage xenophobia and protectionism since workers fear that foreigners are stealing their jobs. Efforts to preserve existing jobs of domestic and native workers include legal barriers against "outsiders" who want jobs, obstacles to immigration, and/or tariffs and similar trade barriers against foreign competitors. High unemployment can also cause social problems such as crime. If people have less disposable income than before, it is very likely that crime levels within the economy will increase. A 2015 study published in The Lancet, estimates that unemployment causes 45,000 suicides a year globally. Sociopolitical
High levels of unemployment can be causes of civil unrest, in some cases leading to revolution, particularly totalitarianism. The fall of the Weimar Republic in 1933 and Adolf Hitlers rise to power, which culminated in World War II and the deaths of tens of millions and the destruction of much of the physical capital of Europe, is attributed to the poor economic conditions in Germany at the time, notably a high unemployment rate of above 20%; see Great Depression in Central Europe for details. However the hyperinflation in the Weimar Republic is not directly blamed for the Nazi rise. Hyperinflation occurred primarily in 1921 to 1923, the year of Hitlers Beer Hall Putsch. Although hyperinflation has been blamed for damaging the credibility of democratic institutions, the Nazis did not assume government until 1933, ten years after the hyperinflation but in the midst of high unemployment.