Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2019; 7(21): 3583-3589
Published online Nov 6, 2019. doi: 10.12998/wjcc.v7.i21.3583
Out-of-hospital cardiac arrest in a young adult survivor with sequelae of childhood Kawasaki disease: A case report
Ke-Fu Zhu, Li-Jiang Tang, Shao-Ze Wu, Yi-Min Tang
Ke-Fu Zhu, Li-Jiang Tang, Shao-Ze Wu, Yi-Min Tang, Department of Cardiology, Zhejiang Hospital, Hangzhou 310013, Zhejiang Province, China
Author contributions: Zhu KF collected the patient’s clinical data and drafted the manuscript; Tang LJ reviewed the literature; Wu SZ contributed to analysis and interpretation of the imaging; Tang YM collected the patient’s clinical data and revised the manuscript; All authors issued final approval for the version to be submitted.
Supported by the Program of Zhejiang Chinese medicine science and technology, No. 2018ZQ004
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: 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/
Corresponding author: Yi-Min Tang, MD, Associate Chief Physician, Department of Cardiology, Zhejiang Hospital, Lingyin Road No. 12, Hangzhou 310013, Zhejiang Province, China. tangyimin_zh@163.com
Telephone: +86-571-87987373 Fax: +86-571-87987373
Received: June 10, 2019
Peer-review started: June 10, 2019
First decision: September 9, 2019
Revised: September 29, 2019
Accepted: October 15, 2019
Article in press: October 15, 2019
Published online: November 6, 2019
Processing time: 151 Days and 22.1 Hours
Abstract
BACKGROUND

Kawasaki disease (KD) is an acute type of systemic vasculitis involving small to medium-sized muscular arteries and outbreaks during childhood. KD can cause myocardial ischemia, infarction, and sudden cardiac arrest. We present a case of a young adult survivor of out-of-hospital cardiac arrest as late KD sequelae.

CASE SUMMARY

A 29-year-old man with presumed acute KD history at the age of 5 suddenly lost consciousness while jogging and was diagnosed a sudden cardiac arrest by an emergency doctor. After about 10 min cardiopulmonary resuscitation, return of spontaneous circulation was achieved, and the patient was transferred to our hospital. A coronary computed tomography angiogram and coronary angiography revealed extensive calcifications of left anterior descending and right coronary artery aneurysms. The patient was an active individual who took exercise regularly and claimed no previous symptoms of chest pain or shortness of breath on exertion. The most possible cause of his sudden cardiac arrest could be presumed as a thrombus within the coronary artery aneurysms. After that, a thromboembolism induced extensive ischemia, and this ischemia-induced arrhythmia led to a cardiac arrest.

CONCLUSION

Few patients who suffer a late sequela of KD can survive from out-of-hospital cardiac arrest. Medications, surgical intervention, and active follow-up are extremely important for this patient to prevent occurrence of adverse events in the future.

Keywords: Cardiac arrest; Young adult; Kawasaki disease; Coronary artery aneurysm; Case report

Core tip: Kawasaki disease (KD) is an acute type of systemic vasculitis involving small to medium-sized muscular arteries in childhood. One of the most severe complications of KD is coronary artery aneurysms. We reported a case of out-of-hospital cardiac arrest of a young adult survivor, who probably had KD during childhood. Undiagnosed and untreated KD can have serious long-term sequelae. Few patients who suffer a late sequela of KD can survive from out-of-hospital cardiac arrest. Timely cardiopulmonary resuscitation is very critical for survival of sudden cardiac arrest.