Cardiac Complications are the leading cause of mortality after orthotopic liver transplantation. Advanced liver disease patients with positive DSE are at increased risk. CAD, beta blocker use and NASH are independently associated with cardiac events.

A 59-year-old man presents to the hospital following a syncopal episode after a low-speed car accident without visible injuries. He was diagnosed with stress cardiomyopathy and severe triple-vessel coronary artery disease. The case was complicated by complete heart block that culminated in refractory cardiogenic shock. Literature and current approach are reviewed.