Six Kawasaki disease patients with acute coronary artery thrombosis.
- Author:
Shu-lai ZHOU
1
;
Jian-ping LUO
1
;
Yan-qi QI
1
;
Yu-guang LIANG
1
;
Wei WANG
1
;
Fang-qi GONG
2
Author Information
- Publication Type:Journal Article
- MeSH: Acute Disease; Anticoagulants; administration & dosage; therapeutic use; Aspirin; administration & dosage; therapeutic use; Child, Preschool; Coronary Aneurysm; diagnosis; drug therapy; etiology; Coronary Thrombosis; diagnosis; drug therapy; etiology; Echocardiography; Electrocardiography; Female; Fibrinolytic Agents; administration & dosage; therapeutic use; Humans; Immunoglobulins, Intravenous; administration & dosage; therapeutic use; Infant; Infant, Newborn; Male; Mucocutaneous Lymph Node Syndrome; complications; drug therapy; Myocardial Infarction; diagnosis; etiology; mortality; Retrospective Studies
- From: Chinese Journal of Pediatrics 2013;51(12):925-929
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo improve the awareness of acute coronary artery thrombosis in Kawasaki disease (KD).
METHODSix KD patients with acute coronary artery thrombosis (Jan. 2004 to Jan. 2013) were studied retrospectively. The basic information, clinical manifestations, laboratory data, echocardiography and electrocardiography (ECG), method and consequence of thrombolytic therapy were analyzed.
RESULTThe mean age of patients with coronary artery thrombosis (5 males and 1 female) was (17.2 ± 11.3) months.Five cases had thrombosis in left coronary artery (LCA), and four cases had thrombosis in aneurysm of left anterior descending artery (LAD). One case had thrombosis in both left and right coronary artery (RCA).One case died. Maximum thrombus was about 1.60 cm × 0.80 cm, locating in LAD. The diameter of LCA and RCA was (0.44 ± 0.07) cm and (0.45 ± 0.07) cm. Two patients showed abnormal ECG. Case 3 showed ST segment depression in lead V5. Case 6 showed myocardial infarction.In acute phase of KD, three patients received treatment with intravenous immunoglobin (IVIG), five patients were treated with aspirin.In sub-acute and convalescent phase of KD, all patients were treated with low-dose aspirin.Warfarin and dipyridamole were applied in 5 patients. All cases were treated with thrombolytic therapy using urokinase and/or heparin. After thrombolytic therapy, echocardiography showed thrombolysis in four cases and no change in one.One patient died of myocardial infarction.
CONCLUSIONMost of acute coronary thrombosis in KD occurred in LAD. KD patients with coronary artery thrombosis are at risk of sudden death due to myocardial infarction.
