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A Case of Multiple Giant Coronary Aneurysms with Large Mural Thrombus due to Kawasaki Disease in a Young Infant

Korean Journal of Pediatrics 2005;48(3):321-326.
Published online March 15, 2005.
A Case of Multiple Giant Coronary Aneurysms with Large Mural Thrombus due to Kawasaki Disease in a Young Infant
Eun Na Choi1, Jeoung Tae Kim1, Yuria Kim1, Byung Won Yoo1, Deok Young Choi1, Jae Young Choi1, Jun Hee Sul1, Sung Kye Lee1, Dong Soo Kim1, Young Hwan Park2
1Department of Pediatrics, Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea
2Department of Cardiovascular Surgery, Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea
가와사끼병 영아에서 발생한 혈전을 동반한 거대관상동맥류 1례
최은나1, 김정태1, 김유리아1, 유병원1, 최덕영1, 최재영1, 설준희1, 이승규1, 김동수1, 박영환2
1연세대학교 의과대학 심장혈관병원 소아심장과
2연세대학교 의과대학 심장혈관외과
Correspondence: 
Jae Young Choi, Email: cjy0122@yumc.yonsei.ac.kr
Abstract
Kawasaki disease is an acute systemic vasculitis of unknown origin. Giant coronary aneurysm is one of the most serious complications, although peripheral artery vasculitis can produce life-threatening events. Myocardial ischemia and infarction can be caused by coronary artery stenosis, aneurysm, and stagnation of blood flow in coronary arteries which triggers thromboembolism. Atypical presentation in young infants often interferes with prompt diagnosis and timely treatment, resulting in poor outcomes. We describe a 3-month-old infant with multiple giant coronary aneurysms with flow stagnation, stenosis and large mural thrombus due to Kawasaki disease. He presented with a prolonged course of severe coronary involvement in spite of all measures to reduce coronary complications. Finally, surgical intervention was tried because of the worsening coronary artery abnormalities. The patient died of acute cardiorespiratory failure shortly after weaning from cardiopulmonary bypass.
Key Words: Mucocutaneous lymph node syndrome , Coronary aneurysm , Coronary thrombosis , Infant , Myocardial ischemia


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