[Six Kawasaki disease patients with acute coronary artery thrombosis].
OBJECTIVE
To improve the awareness of acute coronary artery thrombosis in Kawasaki disease (KD).


METHODS
Six KD patients with acute coronary artery thrombosis (Jan. 2004 to Jan. 2013) were studied retrospectively. The basic information, clinical manifestations, laboratory data, echocardiography and electrocardiography (ECG), method and consequence of thrombolytic therapy were analyzed.


RESULTS
The mean age of patients with coronary artery thrombosis (5 males and 1 female) was (17.2 ± 11.3) months.Five cases had thrombosis in left coronary artery (LCA), and four cases had thrombosis in aneurysm of left anterior descending artery (LAD). One case had thrombosis in both left and right coronary artery (RCA).One case died. Maximum thrombus was about 1.60 cm × 0.80 cm, locating in LAD. The diameter of LCA and RCA was (0.44 ± 0.07) cm and (0.45 ± 0.07) cm. Two patients showed abnormal ECG. Case 3 showed ST segment depression in lead V5. Case 6 showed myocardial infarction.In acute phase of KD, three patients received treatment with intravenous immunoglobin (IVIG), five patients were treated with aspirin.In sub-acute and convalescent phase of KD, all patients were treated with low-dose aspirin.Warfarin and dipyridamole were applied in 5 patients. All cases were treated with thrombolytic therapy using urokinase and/or heparin. After thrombolytic therapy, echocardiography showed thrombolysis in four cases and no change in one.One patient died of myocardial infarction.


CONCLUSIONS
Most of acute coronary thrombosis in KD occurred in LAD. KD patients with coronary artery thrombosis are at risk of sudden death due to myocardial infarction.
Department of Cardiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Shu-lai
SL
Zhou
Department of Cardiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Jian-ping
JP
Luo
Department of Cardiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Yan-qi
YQ
Qi
Department of Cardiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Yu-guang
YG
Liang
Department of Cardiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Wei
W
Wang
Department of Cardiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. Email: gongfangqi@zju.edu.
Fang-qi
FQ
Gong
D000208:Acute Disease; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000188:drug therapy; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D016756:Immunoglobulins, Intravenous; D001241:Aspirin