Acute Myocardial Infarction during the Subacute Phase of Refractory and Incomplete Kawasaki Disease in a Five-year-old Boy.
10.4266/kjccm.2014.29.1.23
- Author:
Chul JIN
1
;
Yeo Hyang KIM
;
Hyung Seop KIM
Author Information
1. Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea.
- Publication Type:Case Report
- Keywords:
electrocardiogram;
immunoglobulin;
Kawasaki disease;
myocardial infarction
- MeSH:
Aneurysm;
Chest Pain;
Coronary Vessels;
Dilatation;
Electrocardiography;
Humans;
Immunoglobulins;
Immunoglobulins, Intravenous;
Infarction;
Male*;
Mortality;
Mucocutaneous Lymph Node Syndrome*;
Myocardial Infarction*;
Myocardial Ischemia;
Prognosis;
Systemic Vasculitis;
Thrombosis;
Young Adult
- From:The Korean Journal of Critical Care Medicine
2014;29(1):23-26
- CountryRepublic of Korea
- Language:English
-
Abstract:
Kawasaki disease (KD) is an acute, systemic vasculitis of childhood. The early mortality of KD results from coronary complications, mainly aneurysmal thrombosis with myocardial infarction, and the subacute phase of KD has the highest risk of mortality. Although there have been reports of ischemic heart disease as late cardiologic sequelae of KD in young adults, acute myocardial infarction caused by coronary complications in the subacute phase of KD is rare. We experienced one pediatric patient who developed coronary artery aneurysm and acute myocardiac infarction (AMI) during the subacute phase of incomplete and intravenous immunoglobulin (IVIG)-nonresponsive KD. The patient was given a good prognosis due to close monitoring and early recognition of AMI. Physicians should carefully monitor KD patients who do not respond to initial IVIG therapy and who show progressive coronary artery dilatation. If such a patient complaints of chest pain and the ECG shows hyperacute T waves, the physician should suspect development of AMI.
