Multiple coronary artery aneurysms in an adult associated with extensive thrombus formation resulting in acute myocardial infarction: successful treatment with intracoronary urokinase, intravenous heparin, and oral anticoagulation.
A 37-yr-old white female was admitted to hospital with an evolving anterior myocardial infarction. Coronary arteriography revealed multiple aneurysms in the left anterior descending (and right) coronary arteries. In the left anterior descending artery, there was evidence of extensive thrombus formation. The patient was successfully treated with intracoronary urokinase, intravenous heparin, and oral warfarin. There was partial thrombolysis in 16 hr and complete thrombolysis noted 6 wk later. This case of multiple coronary aneurysms, secondary to presumed Kawasaki disease, is the first documentation of antemortem intra-aneurysmal coronary thrombosis treated successfully by thrombolytic and anticoagulant therapy.
Myler
R K
RK
San Francisco Heart Institute, Seton Medical Center, Daly City, California 94015.
Schechtmann
N S
NS
Rosenblum
J
J
Collinsworth
K A
KA
Bashour
T T
TT
Ward
K
K
Murphy
M C
MC
Stertzer
S H
SH
D000284:Administration, Oral; D000328:Adult; D006328:Cardiac Catheterization; D003323:Coronary Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*; D014859:Warfarin / Q000008:administration & dosage
D014859:Warfarin; D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator