Acute closure of the left anterior descending artery in a young patient with suspicion of past Kawasaki disease during childhood - A case study

Abstract

Kawasaki disease (KD) is a rare and self-limiting inflammatory disease of medium size blood vessels (mostly of coronary arteries) of unknown etiology. It develops mostly in infants and young children. Its diagnosis is based on typical clinical signs, including: fever, rash, cervical lymphadenopathy, erythema on hands and feet. The inflammatory process may lead to development of aneurysms of coronary arteries and to early atherosclerosis, resulting in acute coronary syndromes in adult patients. We present the case of a 40-years-old male probably post KD in childhood, admitted because of myocardial infarction with ST elevation (STEMI) of the anterior wall, in whom coronarography demonstrated obstruction of LAD and aneurysm of its proximal section. After an unsuccessful angioplasty the patient was qualified for coronary-aortic bypass grafting (CABG) of obstructed LAD, using the MITCAB method. Acute coronary syndromes in patients with history of Kawasaki disease during childhood are described in case reports only, and absence of any clear guidelines makes the analysis of individual cases highly valuable.