| Acute myocardial infarction caused by transient coronary vasospasm in a child with Kawasaki disease and no coronary aneurysms. | |
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MedLine Citation:
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PMID: 20422172 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We report a 15-month old girl with acute myocardial infarction 3 months after treatment for Kawasaki disease (KD); she had no coronary aneurysms. In the first 2 months after KD, she had normal electrocardiograms (ECGs) and echocardiograms that showed mildly dilated coronary arteries. At 3 months, she was asymptomatic but developed ECG changes of anteroseptal MI and increased troponin levels. Echocardiogram showed regional wall-motion abnormalities and decreased left ventricular function. She was admitted and treated with heparin and nitroglycerin drips. Repeat echocardiogram at 24 h showed resolution of wall-motion abnormalities and improved function. Cardiac catheterization showed normal coronary arteries. Her troponin levels normalized within 36 h, and she was discharged on low molecular-weight heparin and aspirin. She has done well since discharge with normal ECGs and echocardiograms during the following 2.5 years. Although coronary vasospasm has been described in young adults with history of KD, we report the first such presentation in a child. This underscores the fact that vascular endothelial dysfunction occurs despite absence of overt coronary aneurysms in patients with KD as well as the need for close follow-up. |
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Authors:
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Subhashini Subramanian; Winston E Gaum |
Publication Detail:
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Type: Case Reports; Journal Article Date: 2010-04-27 |
Journal Detail:
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Title: Pediatric cardiology Volume: 31 ISSN: 1432-1971 ISO Abbreviation: Pediatr Cardiol Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-27 Completed Date: 2010-11-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8003849 Medline TA: Pediatr Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 875-7 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Division of Pediatric Cardiology, Golisano Children's Hospital at Strong Hospital, University of Rochester Medical Center, 601 Elmwood Avenue, Box 631, Rochester, NY 14642, USA. subhashini_subramanian@urmc.rochester.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anticoagulants
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therapeutic use Coronary Aneurysm Coronary Vasospasm / complications*, diagnosis, drug therapy Diagnosis, Differential Drug Therapy, Combination Echocardiography Electrocardiography Female Follow-Up Studies Heparin, Low-Molecular-Weight / therapeutic use Humans Infant Mucocutaneous Lymph Node Syndrome / complications*, diagnosis Myocardial Infarction / diagnosis, drug therapy, etiology* Nitroglycerin / therapeutic use Vasodilator Agents / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Heparin, Low-Molecular-Weight; 0/Vasodilator Agents; 55-63-0/Nitroglycerin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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