Acute myocardial infarction that resulted from poor adherence to medical treatment for giant coronary aneurysm the importance of patient education in the chronic phase of Kawasaki disease

Yoshihiro Motozawa, Hiroki Uozumi, Sonoko Maemura, Ryo Nakata, Keisuke Yamamoto, Masataka Takizawa, Hidetoshi Kumagai, Yuichi Ikeda, Issei Komuro, Hiroshi Ikenouchi

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Coronary arterial complications associated with Kawasaki disease (KD), such as a giant coronary aneurysm, determine the relative risk of future cardiac events and require lifelong medical treatment. Here, we describe a 24-year-old man who developed myocardial infarction due to poor adherence to medical treatment for a giant coronary aneurysm in the chronic phase of KD. He was hospitalized two hours after the onset of chest pain. The presence of the giant coronary aneurysm made primary percutaneous coronary intervention (PCI) difficult. However, we were able to perform primary PCI successfully utilizing previous coronary computed tomography (CT) angiographic pictures as a reference. This case provides valuable insight for the management of coronary arterial complications associated with KD. Patients in the chronic phase of KD are usually asymptomatic, even in the presence of giant coronary aneurysms which have been reported to have a high risk of morbidity and mortality. Therefore, patient education is critical for preventing poor adherence to medical treatment for coronary arterial complications. In preparation for potential coronary intervention in the future, it is also useful to perform coronary CT angiography, coronary magnetic resonance (MR) angiography, and/or coronary angiography on a regular basis while patients remain free from serious cardiac events.

Original languageEnglish (US)
Pages (from-to)551-554
Number of pages4
JournalInternational Heart Journal
Volume56
Issue number5
DOIs
StatePublished - Sep 29 2015

Keywords

  • Adolescent
  • Coronary computed tomography angiography
  • Mucocutaneous lymph node syndrome
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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