Coronary Artery Aneurysm After Kawasaki Disease in a Single Coronary Artery

Toyono, Manatomo; Takagi, Daichi; Oyamada, Jun; Shimada, Shunsuke; Aoki-Okazaki, Mieko; Takahashi, Tsutomu

doi:10.1253/circj.cj-13-0128

Cited by 5 publications

(6 citation statements)

References 8 publications

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“…Twenty-six cases of congenital absence of the RCA have been reported in 24 articles in the last decade ( Table 1 ). 8 – 31 The mean age of patients at the time of diagnosis of congenital absence of the RCA was 53 years. Of the 26 reported cases, 14 patients were women, and 5 of them presented with acute myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

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Congenital absence of the right coronary artery with acute myocardial infarction: report of two cases and review of the literature

et al. 2020

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Congenital absence of the right coronary artery (RCA) is a rare coronary anomaly. Few cases of this condition have been reported. Congenital absence of the RCA is considered as a benign anomaly. However, in certain cases, these patients may develop life-threatening clinical complications that include acute myocardial infarction, stroke, or sudden death. We report two patients who were diagnosed with congenital absence of the RCA and presented with acute myocardial infarction. We discuss our experience in diagnosis and treatment of this disease. Congenital absence of the RCA with acute myocardial infarction is an uncommon clinical emergency. Therefore, early detection, correct diagnosis, and appropriate treatment are important.

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Section: Discussionmentioning

confidence: 99%

“…Of the 26 previously reported cases, 16 had an L-I pattern. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Therefore, the L-I pattern may be more likely to occur than the L-II pattern. Individuals with congenital absence of the RCA present with non-specific clinical features and ECG manifestations.…”

Section: Discussionmentioning

confidence: 99%

Congenital absence of the right coronary artery with acute myocardial infarction: report of two cases and review of the literature

et al. 2020

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“…The majority of patients with KD recover well after treatment; however, coronary artery aneurysms may develop in ~25% of untreated cases (18). Early diagnosis and treatment together with follow-up by echocardiography play important roles for positive outcomes.…”

Section: Discussionmentioning

confidence: 99%

Utility of color Doppler echocardiography combined with clinical markers in diagnosis and prediction of prognosis of coronary artery lesions in Kawasaki disease

Xue

Wang

2020

Exp Ther Med

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The utility of color Doppler echocardiography in the diagnosis and follow-up of Kawasaki disease (KD) with coronary artery lesions (CAL) was analyzed, and the clinical parameters associated with the disease were examined. The general data, the color Doppler echocardiography data and the biochemical indexes from 102 children with KD were analyzed. The patients were divided into a CAL group and a non-coronary artery lesion (NCAL) group based on the presence or absence of CAL. The risk factors for CAL in KD were screened by univariate and multivariate analyses. Among the 102 cases, CAL complications were identified in 47 cases (46.08%). Compared with the NCAL group, the CAL group showed significantly higher incidences of fever duration, increased levels of N-terminal pro B-type natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), C-reactive protein (CRP), intravenous immunoglobulin resistance, erythrocyte sedimentation rate (ESR), platelets, alanine aminotransferase and aspartate aminotransferase, and significantly lower serum albumin levels (P<0.05). According to the multivariate analysis, fever duration [odds ratio (OR)=2.014], NT-proBNP (OR=3.004), cTnI level (OR=2.638), ESR (OR=1.461) and CRP elevation (OR=1.094) were predictors of CAL in KD. During convalescence, the left and right coronary artery diameters in the CAL group significantly decreased (P<0.05). Color Doppler echocardiography can observe the condition of coronary artery disease in patients with KD in real time and predicts its outcomes, which may be helpful for early diagnosis and long-term follow-up. Fever duration, cTnI, NT-proBNP and ESR levels were correlated with coronary artery diameter, of which the comprehensive use may be more accurate in determining the occurrence of CAL in KD.

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“…However, the evaluation of coronary arteries by echocardiography is sometimes difficult because children with KD are highly irritable and because their coronary artery system might have unknown congenital anomalies. 1,2 Herein, we report a case of KD in which diagnosis was complicated by the presence of a single right coronary artery.…”

Section: Introductionmentioning

confidence: 99%

Child with Kawasaki Disease Complicated by A Single Right Coronary Artery

Nakagawa

Ishido

Iwamoto

et al. 2021

Clin Med Insights Cardiol

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A 3-year-old boy was referred to our hospital for management of Kawasaki disease at 5 days of illness. Echocardiographic examination on admission suggested aneurysmal dilation of the right coronary artery and a possible aorta-left main trunk connection. However, detailed echocardiography at 12 days of illness revealed an abnormal bifurcation of the proximal right coronary artery and no real connection of the aorta-left main trunk, all of which indicated the presence of a single right coronary artery. These diagnoses were confirmed by selective coronary angiography, which was performed later. Considering the difficulties in diagnosing congenital coronary anomalies, which may increase the risk of future fatal events, knowing the disease entity of the congenital coronary arterial anomaly is important for the accurate evaluation of coronary arteries in patients with Kawasaki disease. To the best of our knowledge, this is the first case report of a patient with Kawasaki disease complicated by a single right coronary artery; however, following a search of the literature, we found a brief conference abstract written in Japanese relating to the same clinical condition.

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Coronary Artery Aneurysm After Kawasaki Disease in a Single Coronary Artery

Cited by 5 publications

References 8 publications

Congenital absence of the right coronary artery with acute myocardial infarction: report of two cases and review of the literature

Congenital absence of the right coronary artery with acute myocardial infarction: report of two cases and review of the literature

Utility of color Doppler echocardiography combined with clinical markers in diagnosis and prediction of prognosis of coronary artery lesions in Kawasaki disease

Child with Kawasaki Disease Complicated by A Single Right Coronary Artery

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