scispace - formally typeset

Journal ArticleDOI

Enfermedad coronaria aneurismática severa en un adolescente con angina de esfuerzo secundaria a enfermedad de Kawasaki no diagnosticada previamente

09 Jan 2007-Revista Medica De Chile (Sociedad Médica de Santiago)-Vol. 135, Iss: 9, pp 1182-1185

TL;DR: A 16 year old male with a history of angina on exertion and a treadmill exercise test was positive for ischemia in concordance with a Thallium-201scintigraphy showing a septal and infero-posterior reversible myocardial perfusion defect.

AbstractWe report a 16 year old male with a history of angina on exertion.A treadmill exercise test was positive for ischemia in concordance with a Thallium-201scintigraphy showing a septal and infero-posterior reversible myocardial perfusion defect.Coronary angiography disclosed severe aneurysmal coronary artery disease. Bilateral internalmammary coronary artery bypass grafting was successfully performed. Kawasaki disease is themost likely etiology, although not confirmed (Rev Med Chile 2007; 135: 1182-85).(

Topics: Coronary artery disease (62%), Angina (60%), Kawasaki disease (57%), Angiography (52%)

...read more

Content maybe subject to copyright    Report

Citations
More filters

Journal Article
TL;DR: When the previously reported cases of six similar patients were taken into consideration, the only predictor of successful PTCA seemed to be the time elapsed between the onset of Kawasaki disease and perfo...
Abstract: Background Percutaneous transluminal coronary angioplasty (PTCA) has rarely been performed on patients with coronary lesions that result from Kawasaki disease. In this study, we retrospectively evaluated the effectiveness of PTCA in five patients with coronary arterial stenosis that resulted from Kawasaki disease and reviewed previous reports for possible indicators of PTCA effectiveness. Methods and Results Five patients, ranging in age from 2 to 16 years (median, 8 years), underwent conventional PTCA for localized stenosis. The lesion targeted for PTCA was located in the middle right coronary artery of three patients and in the left anterior descending artery in two patients. In four of the five patients, PTCA was angiographically effective, with stenosis rates improving from 84±10% to 33±11% (P<.05). When the previously reported cases of six similar patients were taken into consideration, the only predictor of successful PTCA seemed to be the time elapsed between the onset of Kawasaki disease and perfo...

24 citations



References
More filters


Journal ArticleDOI
TL;DR: It is suggested that aneurysmal coronary disease does not represent a distinct clinical entity but is, rather, a variant of coronary atherosclerosis.
Abstract: To examine the clinical and historical features and the natural history of aneurysmal coronary disease, we reviewed the registry data of the Coronary Artery Surgery Study (CASS). Nine hundred seventy-eight patients, representing 4.9% of the total registry population, were identified as having aneurysmal disease. No significant differences were noted between aneurysmal and nonaneurysmal coronary disease patients when features such as hypertension, diabetes, lipid abnormalities, family history, cigarette consumption, incidence of documented myocardial infarction, presence and severity of angina, and presence of peripheral vascular disease were examined. In addition, no difference in 5-year medical survival was noted between these two groups. These findings suggest that aneurysmal coronary disease does not represent a distinct clinical entity but is, rather, a variant of coronary atherosclerosis.

845 citations


Journal ArticleDOI
TL;DR: A history of antecedent Kawasaki disease should be sought in all young adults who present with acute myocardial infarction or sudden death, andCoronary artery aneurysms and calcification on chest radiography were unusual features in this group of patients.
Abstract: Kawasaki disease is an acute vasculitis of unknown etiology that predominantly affects children <5 years of age. Structural damage to the coronary arteries after the acute, self-limited illness is detected by echocardiography in ∼25% of untreated patients. The long-term effects of the acute coronary arteritis are unknown. To define the spectrum of clinical disease in young adults that can be attributed to Kawasaki disease in childhood, we performed a retrospective survey of cases reported in the English and Japanese published data of adult coronary artery disease attributed to antecedent Kawasaki disease. The mean age at presentation with cardiac sequelae was 24.7 ± 8.4 years (range 12 to 39) for the 74 patients identified with presumed late sequelae of Kawasaki disease. Symptoms at the time of presentation with cardiac sequelae included chest pain/myocardial infarction (60.8%), arrhythmia (10.8%) and sudden death (16.2%). These symptoms were precipitated by exercise in 82% of patients. One-third of the patients in whom a chest radiograph was taken had ring calcification. Angiographic findings included coronary artery aneurysm (93.2%) and coronary artery occlusion (66.1%). Extensive development of collateral vessels was reported in 44.1% of patients. Autopsy findings included coronary artery aneurysms (100%0 and coronary artery occlusion (72.2%). The acute vasculitis of Kawasaki disease can results in coronary artery damage and rheologic changes predisposing to thrombus formation or progressive atherosclerotic changes that may remain clinically silent for many years. Coronary artery aneurysms and calcification on chest radiography were unusual features in this group of patients. A history of antecedent Kawasaki disease should be sought in all young adults who present with acute myocardial infarction or sudden death.

290 citations


Journal ArticleDOI
TL;DR: A clinical guideline for the diagnosis and treatment of Kawasaki disease in the UK based on the best available evidence to date is proposed, and areas of practice where evidence is anecdotal or based on retrospective data are highlighted.
Abstract: This article proposes a clinical guideline for the diagnosis and treatment of Kawasaki disease in the UK based on the best available evidence to date, and highlights areas of practice where evidence is anecdotal or based on retrospective data. Future research as proposed by the London Kawasaki Disease Research Group is outlined, and clinicians are invited to prospectively enrol their suspected cases into this collaborative research project.

173 citations