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Transient Q-waves in an infant with asymptomatic myocardial infarction due to Kawasaki disease

Published online by Cambridge University Press:  06 December 2018

Daisuke Akagawa
Affiliation:
Department of Pediatrics, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Japan
Noriko Motoki*
Affiliation:
Department of Pediatrics, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Japan
Akira Hachiya
Affiliation:
Department of Pediatrics, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Japan
Yohei Akazawa
Affiliation:
Department of Pediatrics, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Japan
*
Author for correspondence: Noriko Motoki, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan. Tel: 81-263-37-2642; E-mail: [email protected]

Abstract

Giant coronary artery aneurysms are a complication of Kawasaki disease and can be fatal if associated with thrombosis. We describe the clinical outcome of a boy with Kawasaki disease who exhibited “supergiant” coronary artery aneurysms at the age of 14 months and, despite treatment with anticoagulant and antiplatelet medication, developed a left coronary artery thrombosis and presented following a myocardial infarction at 2 years old. Although his symptoms were minimal, the myocardial infarction was identified by abnormal Q-waves and giant negative T-waves in precordial leads of routine electrocardiography. Intensive anticoagulant therapy combining heparin injections and high-dose warfarin was successful. The abnormal Q-waves and negative T-waves had completely disappeared 2 weeks later, likely in association with confirmed reperfusion. On the basis of prompt identification of abnormal Q-waves by electrocardiography, the patient could avoid thrombolytic therapy and catheter or surgical intervention.

Type
Brief Report
Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Akagawa D, Motoki N, Hachiya A, Akazawa Y. (2018) Transient Q-waves in an infant with asymptomatic myocardial infarction due to Kawasaki disease. Cardiology in the Young page 231 of 234. doi: 10.1017/S1047951118001919

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