Myocardial infarction in Kawasaki disease: Clinical analyses in 195 cases

Kato, Hirohisa; Ichinose, Eisei; Kawasaki, Tomisaku

doi:10.1016/s0022-3476(86)80928-3

Cited by 303 publications

(132 citation statements)

References 9 publications

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“…Cardiac failure is caused by myocardial damage caused by myocardial infarction, and severe myocardial damage often results in fatal arrhythmias. 17 The extent of myocardial damage greatly influences the prognosis. To prevent the damage, the timing of coronary revascularization needs to be optimal.…”

Section: Discussionmentioning

confidence: 99%

National Survey of Coronary Artery Bypass Grafting for Coronary Stenosis Caused by Kawasaki Disease in Japan

Tsuda

Kitamura²

2004

Circulation

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Background-We surveyed the national experience of coronary artery bypass grafting (CABG) for coronary sequelae of Kawasaki disease (kDa) in 2002. Methods and Results-A questionnaire was returned from 323/552 (59%) institutions. Two hundred forty-four patients (188 male 56 female) since 1975 were identified. The mean number of grafts was 1.8 and the age at operation ranged from 1 to 44 years (median 11 years). The interval from the onset of kDa to operation ranged from 1 month to 42 years (median 8 years), whereas the follow-up period was from 7 days to 25 years (median 5 years). Previous myocardial infarction was found in 70 patients (28%). When the age at operation was older than 12 years, patency rates for internal thoracic artery grafts (ITA) at 1, 5, and 15 years were 95%, 91%, and 91%, respectively (nϭ156). When the age at operation was younger than 12 years, the corresponding values were significantly lower, with 1, 5, and 15 years being 93%, 73%, and 65%, respectively (nϭ146) (PϽ0.05). Reoperation was performed in 14 patients (6%

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Section: Discussionmentioning

confidence: 99%

National Survey of Coronary Artery Bypass Grafting for Coronary Stenosis Caused by Kawasaki Disease in Japan

Tsuda

Kitamura²

2004

Circulation

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“…204 Most experts agree that surgery is indicated after recurrent MI because the prognosis is so unfavorable. 205,206 …”

Section: Surgical Managementmentioning

confidence: 99%

“…206 The highest risk of MI occurs in the first year after onset of the disease, and most fatal attacks are associated with obstruction in either the LMCA or both the RCA and LAD. 206 Serial stress tests and myocardial imaging are mandatory in the management of patients with Kawasaki disease and significant coronary artery disease so that the need for coronary angiography and for surgical or transcatheter intervention can be determined.…”

Section: Course Of Patients With Persistent Coronary Artery Abnormalimentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease

Newburger¹,

Takahashi²,

Gerber³

et al. 2004

Circulation

1,614

818

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Background— Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in ∼15% to 25% of untreated children and may lead to ischemic heart disease or sudden death. Methods and Results— A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for ≥5 days and ≤4 classic criteria should undergo echocardiography, receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor-α antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata. Conclusions— Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients.

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“…They may cause sudden death or ischemic heart disease as a result of thrombotic or stenotic occlusion of coronary arteries (3). Two-dimensional echocardiography and selective coronary angiography are standard methods to evaluate coronary artery lesions; however, these are limited to the assessment of wall morphology.…”

Section: Introductionmentioning

confidence: 99%

Intravascular Ultrasound Findings of Coronary Wall Morphology in a Child with Kawasaki Disease

et al. 2001

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INTRODUCTIONKawasaki disease (KD) is an acute febrile vasculitis affecting primarily infants and young children, and 15% to 25% of affected children may subsequently develop coronary artery aneurysms, if not treated (1, 2). They may cause sudden death or ischemic heart disease as a result of thrombotic or stenotic occlusion of coronary arteries (3). Two-dimensional echocardiography and selective coronary angiography are standard methods to evaluate coronary artery lesions; however, these are limited to the assessment of wall morphology. Recent progress in intravascular ultrasound (IVUS) technology allows detailed visualization of morphological changes in vascular wall. However, only a limited number of studies have been reported on the coronary artery using IVUS imaging in patients with KD, and the intervals from the onset of the illness to the time of the IVUS study ranged from 7 to 16 yr (4-6).We illustrate IVUS findings of coronary wall morphology at 22 months after the onset of the disease in a girl with coronary aneurysms due to KD. CASE REPORTA 4-yr-old girl developed fever (39℃), reddening of the pharynx and a tender left-sided cervical adenopathy. She was tentatively diagnosed as having a streptococcal pharyngitis and oral cephalosporin was given at a primary care clinic, but her illness worsened with the appearance of erythematous swelling of both hands, arthralgia, myalgia, and abdominal pain. She was transferred to our hospital on 9th day of the disease.At admission, her general condition was poor and pyrexia (38.5℃), tachycardia (130/min), and arthralgia on both knees and ankles were noted. Bilateral conjunctival injections and oral involvement including strawberry tongue, mucosal hyperemia, and cracked and erythematous lips were evident. There was no cervical lymphadenopathy. Erythematous swelling of both hands and feet was also noted. There was a leukocytosis of 17,500/ L with 93% neutrophils, 6% lymphocytes and the platelet count was 236,000/ L. The erythrocyte sedimentation rate was increased to 132 mm/hr and the Creactive protein level, 30.5 mg/dL. Bacteriologic and serologic studies were negative. The electrocardiogram showed normal pattern. The initial echocardiogram showed aneurysms of the proximal right coronary artery with a maximum diameter of 9 mm, and dilatation of the mid-left anterior descending coronary artery with a diameter of 5 mm. The patient was immediately treated with intravenous gamma globulin (2 g/kg) and salicylate (100 mg/kg/day). The fever disappeared within 24 hr and all other clinical signs within a few days after the initiation of treatment.During follow-up, the patient had been treated with salicylate (5 mg/kg/day) and dipyridamole (4 mg/kg/day). Selective coronary angiography was performed to confirm the Intravascular ultrasound (IVUS) imaging was performed to assess the coronary wall morphology in detail at 22 months after the onset of Kawasaki disease in a girl who had developed coronary aneurysms at 4 yr of age. The sites of persistent aneurysms demonstrated a dila...

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Myocardial infarction in Kawasaki disease: Clinical analyses in 195 cases

Cited by 303 publications

References 9 publications

National Survey of Coronary Artery Bypass Grafting for Coronary Stenosis Caused by Kawasaki Disease in Japan

National Survey of Coronary Artery Bypass Grafting for Coronary Stenosis Caused by Kawasaki Disease in Japan

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease

Intravascular Ultrasound Findings of Coronary Wall Morphology in a Child with Kawasaki Disease

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