Korean J Crit Care Med.  2014 Feb;29(1):23-26. 10.4266/kjccm.2014.29.1.23.

Acute Myocardial Infarction during the Subacute Phase of Refractory and Incomplete Kawasaki Disease in a Five-year-old Boy

• Jin C
• Kim YH
• Kim HS

• KMID: 2227799
• DOI: http://doi.org/10.4266/kjccm.2014.29.1.23

Abstract

Kawasaki disease (KD) is an acute, systemic vasculitis of childhood. The early mortality of KD results from coronary complications, mainly aneurysmal thrombosis with myocardial infarction, and the subacute phase of KD has the highest risk of mortality. Although there have been reports of ischemic heart disease as late cardiologic sequelae of KD in young adults, acute myocardial infarction caused by coronary complications in the subacute phase of KD is rare. We experienced one pediatric patient who developed coronary artery aneurysm and acute myocardiac infarction (AMI) during the subacute phase of incomplete and intravenous immunoglobulin (IVIG)-nonresponsive KD. The patient was given a good prognosis due to close monitoring and early recognition of AMI. Physicians should carefully monitor KD patients who do not respond to initial IVIG therapy and who show progressive coronary artery dilatation. If such a patient complaints of chest pain and the ECG shows hyperacute T waves, the physician should suspect development of AMI.

Keyword

electrocardiogram; immunoglobulin; Kawasaki disease; myocardial infarction

MeSH Terms

Aneurysm
Chest Pain
Coronary Vessels
Dilatation
Electrocardiography
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Infarction
Male*
Mortality
Mucocutaneous Lymph Node Syndrome*
Myocardial Infarction*
Myocardial Ischemia
Prognosis
Systemic Vasculitis
Thrombosis
Young Adult
Immunoglobulins
Immunoglobulins, Intravenous