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Coronary-Artery Occlusion from Kawasaki’s Disease 因川崎病引起的冠狀動(dòng)脈閉塞
發(fā)布時(shí)間:2019-10-28 11:18:34    閱讀:5826
      An 18-year-old man presented to the emergency department with chest pain. He had a history of Kawasaki’s disease which had been diagnosed when he was 11 years of age. Despite treatment with intravenous immune globulin, coronary-artery aneurysms were detected on imaging (Panel A shows a coronary angiogram obtained 3 years before the current presentation). At the time of the current presentation, his medications included aspirin and warfarin.

18歲男孩因胸痛入急診科接受治療,。該患11歲有川崎病,,盡管靜脈注射免疫球蛋白,但影像呈現(xiàn)有冠狀動(dòng)脈瘤(A處為三年前冠脈血管造影影像)目前服用阿斯匹林和華法令,。

An electrocardiogram showed ST-segment elevations in leads V1 to V3   Emergency coronary angiography revealed occlusion of the left anterior descending artery. Kawasaki’s disease is an acute, idiopathic, self-limiting vasculitis that primarily affects children. Clinical features include fever, nonexudative conjunctivitis in both eyes, mucositis,cervical lymphadenopathy, polymorphous rash, and changes in the hands and feet.

心電圖顯示V1 -3導(dǎo)聯(lián)ST段抬高,急診冠狀動(dòng)脈造影顯示左前降動(dòng)脈閉塞(圖B,。川崎病是一種急性,、先天性、自限性脈管炎,,該病早期影響兒童,。臨床表現(xiàn)為發(fā)熱、雙眼非滲出性結(jié)膜炎,、粘膜炎,、頸椎淋巴結(jié)病、多型皮疹及手足改變等,。

Because not all these features are necessarily present and there is no specific diagnostic test for Kawasaki’s disease, the diagnosis may be missed in childhood or occur at such an early age that the adult patient has no recollection of illness. Affected children are at risk for cardiovascular complications. The patient underwent coronary-artery bypass surgery. At follow-up 3 years after presentation, he was doing well and had no further cardiac symptoms.

因?yàn)?/span>以上特征不能表現(xiàn)出來(lái),,而且對(duì)川崎病沒(méi)有專門的診斷檢驗(yàn)兒童期忽略診斷,,或早年發(fā)病,,成年患者記不得有無(wú)既往史患病兒童有心血管并發(fā)癥的風(fēng)險(xiǎn),。該患接受了冠狀動(dòng)脈搭橋手術(shù),。術(shù)后隨訪3年,患者恢復(fù)良好,,無(wú)其心臟癥狀,。




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