[Aftermaths of lesions of coronary arteries in Kawasaki disease].
Kawasaki disease, also known as cutaneous-mucous-glandular mucocutaneous glandular syndrome, is acute systemic vasculitis of small-to-medium calibre arteries, frequently involving coronary arteries, affect almost exceptionally children, with reports concerning cases of Kawasaki syndrome in 20-to-30-year-old adults being extremely rare. The most serious manifestation of Kawasaki disease is coronaritis and formation of coronary artery aneurysms. The dynamics of the formed coronary aneurysms and, consequently, the fate of patients may be different. Thrombosis of an aneurysm in the early period of the disease and stenosing of the affected coronary artery later on present possible complications of Kawasaki disease and potential causes of myocardial infection in young adults. Increased risk of coronary artery thromboses in Kawasaki disease is conditioned by a decrease in velocity of blood flow and its turbulent pattern in the aneurysms, endothelial dysfunction due to currently existing or endured coronaritis and thrombocytosis typical of this pathology. Predisposing factors of coronary artery stenosing are unfavourable haemodynamic conditions appearing at the sites of the "entry" and "exit" of the aneurysm. Described herein are two case reports of myocardial infarction, one of which being a complication of an acute case of Kawasaki disease in a 29-year-old patient, with the second one being a consequence of coronary artery stenosing in a 25-year-old patient who had endured Kawasaki disease in his childhood.
Municipal Clinical Hospital No5, Nizhniy Novgorod, Russia.
A A
AA
Vostokova
Nizhniy Novgorod State Medical Academy of the Russian Federation Health Ministry, Nizhniy Novgorod, Russia.
E A
EA
Grunina
Municipal Clinical Hospital No30, Nizhniy Novgorod, Russia.
A V
AV
Klemenov
D000328:Adult; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000209:etiology / Q000503:physiopathology; D003328:Coronary Thrombosis / Q000209:etiology / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology*; D003937:Diagnosis, Differential; D019468:Disease Management; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D062072:Patient Acuity; D016896:Treatment Outcome