Lee J, Seo J, Shin YH, Jang AY, Suh SY. ST-segment elevation myocardial infarction in Kawasaki disease: A case report and review of literature. World J Clin Cases 2022; 10(26): 9368-9377 [PMID: 36159436 DOI: 10.12998/wjcc.v10.i26.9368]
Corresponding Author of This Article
Soon Yong Suh, PhD, Associate Professor, Division of Cardiology, Department of Internal Medicine, Gachon University, Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon 21565, South Korea. ssy@gilhospital.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 16, 2022; 10(26): 9368-9377 Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9368
ST-segment elevation myocardial infarction in Kawasaki disease: A case report and review of literature
Joonpyo Lee, Jeongduk Seo, Yong Hoon Shin, Albert Youngwoo Jang, Soon Yong Suh
Joonpyo Lee, Jeongduk Seo, Yong Hoon Shin, Albert Youngwoo Jang, Soon Yong Suh, Division of Cardiology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon 21565, South Korea
Author contributions: Lee J, Jang Y, and Suh SY contributed to conceptualization and design and methodology and visualization; Lee J, Seo J, Shin YH, Jang Y, and Suh SY are responsible for validation; Lee J, Jang Y, and Suh SY participated in original draft preparation; Lee J, Jang Y, and Suh SY reviewed and edited manuscript; Suh SY contributed to supervision and project administration; all authors issued their final approval for the version to be submitted.
Informed consent statement: A written informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: The authors have nothing to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Soon Yong Suh, PhD, Associate Professor, Division of Cardiology, Department of Internal Medicine, Gachon University, Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon 21565, South Korea. ssy@gilhospital.com
Received: April 13, 2022 Peer-review started: April 13, 2022 First decision: May 12, 2022 Revised: May 24, 2022 Accepted: August 5, 2022 Article in press: August 5, 2022 Published online: September 16, 2022 Processing time: 141 Days and 18.1 Hours
Abstract
BACKGROUND
Kawasaki disease (KD) is an acute self-limiting febrile vasculitis that occurs during childhood and can cause coronary artery aneurysm (CAA). CAAs are associated with a high rate of adverse cardiovascular events.
CASE SUMMARY
A Korean 35-year-old man with a 30-year history of KD presented to the emergency room with chest pain. Emergent coronary angiography was performed as ST-segment elevation in the inferior leads was observed on the electrocardiogram. An aneurysm of the left circumflex (LCX) coronary artery was found with massive thrombi within. A drug-eluting 4.5 mm 23 mm-sized stent was inserted into the occluded area without complications. The maximal diameter of the LCX was 6.0 mm with a Z score of 4.7, suggestive of a small aneurysm considering his age, sex, and body surface area. We further present a case series of 19 patients with KD, including the current patient, presenting with acute coronary syndrome (ACS). Notably, none of the cases showed Z scores; only five patients (26%) had been regularly followed up by a physician, and only one patient (5.3%) was being treated with antithrombotic therapy before ACS occurred.
CONCLUSION
For KD presenting with ACS, regular follow up and medical therapy may be crucial for improved outcomes.
Core Tip: Kawasaki disease can lead to coronary artery aneurysms. The presence of a coronary artery aneurysm increases the risk of developing acute coronary syndrome. However, we found that proper long-term medical care or regular examination had not been provided to the 19 previously reported patients in this case series. Thus, based on the Z scores, our data highlight the importance of meticulous care by a cardiac specialist.
