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Two females with coronary artery occlusion caused by presumed Kawasaki disease would have delivered without recognition of ischaemic heart disease

Published online by Cambridge University Press:  08 May 2020

Etsuko Tsuda Open the ORCID record for Etsuko Tsuda [Opens in a new window] ,
Takashi Noda  and
Teruo Noguchi
Etsuko Tsuda*
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Takashi Noda
Affiliation:
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
Teruo Noguchi
Affiliation:
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
*
Author for correspondence: Etsuko Tsuda, Department of Pediatric cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan. Tel: +81 06 6170 1070; Fax: +81 06 6170 1782. E-mail: [email protected]
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Abstract

We report two females with coronary artery occlusion caused by presumed Kawasaki disease that delivered children without any special treatment. After a 58-year-old female had ventricular tachycardia, a giant coronary artery aneurysm with calcification at the bifurcation of the left coronary artery and segmental stenosis of the right coronary artery were pointed out by CT angiography. She had an episode of sepsis when 3 years old. Further, she remembered chest pain during sleep after that episode. She had delivered twice without any complication during her 20s. Her diagnosis was undiagnosed coronary artery lesions caused by presumed Kawasaki disease and a previous myocardial infarction, and she underwent radiofrequency catheter ablation and implantable cardioverter defibrillator implantation. The other 48-year-old female was accidentally discovered to have coronary artery calcification on CT, while experiencing pneumonia. Her CT angiograms revealed a right coronary artery occlusion and coronary artery calcification at segments 1, 6, and 11. She had a history of “scarlet fever” before 12 months. Premature ventricular contractions were detected, while delivering her first child when 31 years old. However, she was not diagnosed as ischaemic heart disease and delivered twice by a vaginal delivery without any complication. Current guidelines recommend systemic anti-coagulation and anti-platelet therapy for all patients with giant aneurysms resulting from Kawasaki disease in childhood. The two women reported here were fortunate not to have had complications during pregnancy and delivery despite their severe coronary artery aneurysms, which were unrecognised clinically until later in life. They were lucky cases.

Keywords

Kawasaki diseasecoronary artery occlusioncoronary artery calcificationventricular tachycardiadeliverycoronary artery aneurysm
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 6 , June 2020 , pp. 785 - 789
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Kawasaki, T.Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children (In Japanese). Jpn J Allergy 1967; 164: 178–222.Google Scholar
Burns, JC, Shike, H, Gordon, JB, Malhotra, A, Schoenwetter, M, Kawasaki, T.Sequelae of Kawasaki disease in adolescents and young adults. JACC 1996; 28: 253–257.10.1016/0735-1097(96)00099-XCrossRefGoogle ScholarPubMed
Gordon, JB, Daniels, LB, Kahn, AM, et al.The spectrum of cardiovascular lesions requiring intervention in adults after Kawasaki disease. JACC, Cardiovasc Interv 2015; 9: 687–696.CrossRefGoogle Scholar
Tsuda, E, Abe, T, Tamaki, W.Acute coronary syndrome in adult patients with coronary artery lesions caused by Kawasaki disease: review of case reports. Cardiol Young 2011; 21: 74–82.CrossRefGoogle ScholarPubMed
Tsuda, E, Hamaoka, K, Suzuki, H, et al.A survey of the 3-decade outcome for patients with giant aneurysms caused by Kawasaki disease. Am Heart J 2014; 167: 249–258.CrossRefGoogle ScholarPubMed
Gordon, CT, Jimenez-Fernandez, S, Daniels, LB, et al.Pregnancy in women with a history of Kawasaki disease: management and outcomes. BJOG 2014; 121: 1431–1438.CrossRefGoogle ScholarPubMed
Tamaki, W, Tsuda, E, Igarashi, T, Tanaka, N, Fujieda, M.Importance of evaluation of the tight coronary artery by two-dimensional echocardiogramphy in patients after Kawasaki disease: a right parasite approach. Heart Vessels 2015; 30: 178–185.CrossRefGoogle Scholar
Suzuki, A, Kamiya, T. Clinical significance of morphological classification of coronary arterial segmental stenosis due to Kawasaki disease. Am J Cardiol 1993; 71: 1169–1173.CrossRefGoogle Scholar
Tsuda, E, Tsujii, N, Hayama, Y.Stenotic lesions and the maximum diameter of coronary artery aneurysms in Kawasaki disease. J Pediatr 2018; 194: 165–170.CrossRefGoogle ScholarPubMed
Tsujii, N, Tsuda, E, Kanzaki, S, Ishiduka, J, Nakashima, K, Kurosaki, K.Late wall thickening and calcification after Kawasaki disease. J Pediatr 2017; 181: 167–171.CrossRefGoogle ScholarPubMed
Tsuda, E, Tsujii, N, Kimura, K, Suzuki, A.Distribution of Kawasaki disease coronary artery aneurysms and the relationship to coronary artery diameter. Pediatr Cardiol 2017; 38: 932–940.10.1007/s00246-017-1599-4CrossRefGoogle ScholarPubMed
Tsuda, E, Matsuo, M, Kurosaki, K, et al.Clinical features of patients diagnosed as coronary artery lesions caused by presumed Kawasaki disease in adult. Cardiol Young 2007; 17: 84–89.10.1017/S1047951107000169CrossRefGoogle Scholar
Tsuda, E, Hirata, T, Matsuo, O, Abe, T, Sugiyama, H, Yamada, O.The 30-year outcome for patients after myocardial infarction due to coronary artery lesions caused by Kawasaki disease. Pediatr Cardiol 2011; 32: 176–182.10.1007/s00246-010-9838-yCrossRefGoogle ScholarPubMed
Yagi, S, Tsuda, E, Shimizu, W, et al.Two adults requiring implantable defibrillators because of ventricular tachycardia and left ventricular dysfunction caused by presumed Kawasaki disease. Circ J 2005; 69: 870–874.CrossRefGoogle ScholarPubMed
Abe, T, Tsuda, E, Sugiyama, H, Kiso, K, Yamada, O.Risk factors of non-sustained ventricular tachycardia by technetium-perfusion imaging in patients with coronary artery lesions caused by Kawasaki disease. J Cardiol 2019; 73: 358–362.CrossRefGoogle ScholarPubMed
Nakaoka, H, Tsuda, E, Morita, Y, Kurosaki, K.Cardiac function in coronary artery occlusions after Kawasaki disease by magnetic resonance imaging. Circ J. 2020 (in press).CrossRefGoogle ScholarPubMed
Tsuda, E, Kawamata, K, Neki, R, et al.Nationwide survey of pregnancy and delivery in patients with coronary arterial lesions caused by Kawasaki disease in Japan. Cardiol Young 2006; 16: 173–178.CrossRefGoogle ScholarPubMed
JCS/ JSCS 2020 Guideline on diagnosis and management of cardiovascular sequelae in Kawasaki disease (in press).Google Scholar
Satoh, H, Sano, M, Suwa, K, et al.Pregnancy-related acute myocardial infarction in Japan – a review of epidemiology, etiology and treatment from case reports. Circ J 2013; 77: 725–733.CrossRefGoogle ScholarPubMed
Miura, M, Kobayashi, T, Kaneko, T, et al.Association of severity of voronary aneurysms in patients with Kawasaki disease and risk of later coronary events. JAMA Pediatr 2018; 172: e180030.CrossRefGoogle ScholarPubMed