Document Detail

Acute myocardial infarction caused by transient coronary vasospasm in a child with Kawasaki disease and no coronary aneurysms.
MedLine Citation:
PMID:  20422172     Owner:  NLM     Status:  MEDLINE    
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.
Subhashini Subramanian; Winston E Gaum
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-04-27
Journal Detail:
Title:  Pediatric cardiology     Volume:  31     ISSN:  1432-1971     ISO Abbreviation:  Pediatr Cardiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  875-7     Citation Subset:  IM    
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.
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MeSH Terms
Anticoagulants / therapeutic use
Coronary Aneurysm
Coronary Vasospasm / complications*,  diagnosis,  drug therapy
Diagnosis, Differential
Drug Therapy, Combination
Follow-Up Studies
Heparin, Low-Molecular-Weight / therapeutic use
Mucocutaneous Lymph Node Syndrome / complications*,  diagnosis
Myocardial Infarction / diagnosis,  drug therapy,  etiology*
Nitroglycerin / therapeutic use
Vasodilator Agents / therapeutic use
Reg. No./Substance:
0/Anticoagulants; 0/Heparin, Low-Molecular-Weight; 0/Vasodilator Agents; 55-63-0/Nitroglycerin

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