Ruptured hepatic artery aneurysm and coronary artery aneurysms with myocardial infarction in a 14-year-old boy: New manifestations of mucocutaneous lymph node syndrome

Abstract Kawasaki disease, also known as Kawasaki syndrome or mucocutaneous lymph node syndrome, is a pathology that causes inflammation in the walls of medium sized arteries causing symptoms such as fever, lymphadenopathy, rash, and erythema of eyes, lips, nose, palms and feet. The cause is unknown, although clinical features strongly suggest an infectious etiology. We present the case of a 53-year-old woman, known with Kawasaki disease since childhood, with different associated pathologies, that presented with acute inferior ST elevation myocardial infarction.

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Giant Coronary Artery Aneurysms Involving More Than One Coronary Artery

10.21203/rs.3.rs-353256/v1 ◽

2021 ◽

Author(s):

Matthew S Khouzam ◽

Nayer Khouzam

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Aortic Aneurysm ◽

Right Coronary Artery ◽

Coronary Artery Aneurysm ◽

Artery Aneurysm ◽

Coronary Artery Aneurysms ◽

St Segment ◽

History Of ◽

The Right

Abstract Background: Coronary artery aneurysms are rare findings in patients undergoing coronary angiography. The presence of multiple coronary artery aneurysms located in more than one coronary artery is even more uncommon. The pathophysiology of such aneurysms is unknown, but the majority are often due to atherosclerosis, congenital heart disease, or vasculitis. Case Presentation: We present a rare case of a 78-year-old female patient who presented with unstable angina and non-ST segment elevation myocardial infarction. On coronary angiography she was found to have three separate 1 cm saccular aneurysms involving the proximal left anterior descending coronary artery. The right coronary artery could not be visualized. Computed chest tomography revealed a 6.6 x 6.3 cm saccular aneurysm of the right coronary artery, and a 4.4 cm fusiform aneurysm of the ascending aorta. The patient gave no history of percutaneous coronary intervention or cardiac surgical procedures. She had a previous history of endovascular stenting of an abdominal aortic aneurysm. The sizable right coronary artery aneurysm showed extrinsic compression of both the right atrium and ventricle with right ventricular hypokinesis. Serological studies for vasculitis were all negative. Pathology of the aneurysm wall revealed calcific atherosclerosis without evidence of vasculitis. The patient underwent subtotal resection of the right coronary aneurysm with ligation of the proximal and distal ends of the right coronary artery and double bypass surgery to the left anterior descending and right posterior descending coronary arteries. Conclusion: The presence of multiple, large coronary artery aneurysms is very rare. Treatment can be challenging and should be individualized. Surgical treatment is recommended for giant coronary artery aneurysms to prevent potential complications. Keywords: coronary artery aneurysm, aortic aneurysm, atherosclerosis, non-ST segment 32 elevation myocardial infarction, case report

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Acute ENT admission in Kawasaki disease

The Journal of Laryngology & Otology ◽

10.1017/s0022215100113222 ◽

1990 ◽

Vol 104 (7) ◽

pp. 581-584 ◽

Cited By ~ 8

Author(s):

N. J. Murrant ◽

J. A. CooK ◽

S. H. Murch

Keyword(s):

Lymph Node ◽

Coronary Artery ◽

Young Child ◽

Kawasaki Disease ◽

Cardiac Involvement ◽

Extensive Literature ◽

Mucocutaneous Lymph Node Syndrome ◽

Cent Mortality ◽

Slow Evolution ◽

Lymph Node Syndrome

AbstractKawasaki disease (mucocutaneous lymph node syndrome) is an acute vasculitis of childhood carrying a 1–2 per cent mortality from cardiovasular complications. Despite the extensive literature on Kawasaki disease in paediatric journals, there has been a paucity of documentation in the otolaryngological literature. This is despite the fact that Kawasaki disease may present as an otolaryngological emergency before the diagnosis is established. We describe three cases of Kawasaki disease, all of which presented to the ENT department of this hospital within a period of two months. These cases illustrate the slow evolution characteristic of the disease and highlight the difficulties of diagnosis in the initial febrile stage. We emphasize the importance of considering the diagnosis when treating a young child with a pyrexia resistant to antibiotics, as prompt introduction of therapy may decrease the risk of fatal coronary artery or cardiac involvement.

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Giant right coronary artery aneurysm presenting as an STEMI

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz282 ◽

2019 ◽

Vol 2019 (11) ◽

Author(s):

Jennifer Crabbe ◽

Azar Hussain ◽

Ajith Vijayan ◽

Joseph John ◽

Mahmoud Loubani

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Right Coronary Artery ◽

Coronary Artery Aneurysm ◽

Artery Bypass ◽

Bypass Graft ◽

Artery Aneurysm ◽

Artery Bypass Graft ◽

Coronary Artery Aneurysms ◽

Cardiac Centre

Abstract Giant coronary artery aneurysms are an infrequent finding. They are typically discovered incidentally, rarely presenting with any symptoms. We present the case of a 72-year-old gentleman who presented with an ST elevated myocardial infarction. On investigation, the gentleman was found to have a giant right coronary artery aneurysm which was partially filled with a fresh thrombus. The thrombus occluded the RCA, triggering the myocardial infarction which leads to this gentleman’s presentation to a tertiary cardiac centre. The gentleman underwent a successful resection of the aneurysm and coronary artery bypass graft over the RCA lesion with a saphenous vein conduit. This gentleman has since been discharged from hospital after an uncomplicated postoperative course.

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The Onset of Coronary Artery Aneurysm and Changes of T Cell Subsets and the Effect of High Dose Gammaglobulin Therapy in Mucocutanenous Lymph Node Syndrome

Korean Circulation Journal ◽

10.4070/kcj.1992.22.2.269 ◽

1992 ◽

Vol 22 (2) ◽

pp. 269

Author(s):

Seung Hwan Kim ◽

Mi Ryoung Kim ◽

Young Gyun Oh ◽

Byung Kiu Park ◽

Moon Hong Doh ◽

...

Keyword(s):

Lymph Node ◽

Coronary Artery ◽

T Cell ◽

Coronary Artery Aneurysm ◽

Artery Aneurysm ◽

T Cell Subsets ◽

High Dose ◽

Lymph Node Syndrome

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Are Infantile Periarteritis Nodosa With Coronary Artery Involvement and Fatal Mucocutaneous Lymph Node Syndrome the Same? Comparison of 20 Patients From North America With Patients From Hawaii and Japan

PEDIATRICS ◽

10.1542/peds.59.5.651 ◽

1977 ◽

Vol 59 (5) ◽

pp. 651-662 ◽

Cited By ~ 3

Author(s):

Benjamin H. Landing ◽

Eunice J. Larson

Keyword(s):

Lymph Node ◽

Coronary Artery ◽

Vascular Lesions ◽

Mucocutaneous Lymph Node Syndrome ◽

Autopsy Material ◽

Periarteritis Nodosa ◽

Clinical Reason ◽

Coronary Artery Involvement ◽

Microscopic Features ◽

Lymph Node Syndrome

We reviewed available clinical and pathologic autopsy material from 20 patients with infantile periarteritis nodosa with coronary artery involvement (IPN) from the continental United States, two Hawaiian patients with fatal mucocutaneous lymph node syndrome (MCLS; Kawasaki disease), and three patients with classical periarteritis nodosa (CPN). Comparison of the findings in patients with IPN and in patients with MCLS from Hawaii to material from patients with fatal MCLS from Japan showed no definite clinical reason to distinguish IPN from MCLS; neither gross nor microscopic features of the vascular lesions nor their pattern of distribution appears to warrant separation of IPN from fatal MCLS. CPN differs, both clinically and pathologically, from IPN/MCLS, and may well have a different etiology.

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Myocardial Infarction Due to Coronary Thromboarteritis, Following Acute Febrile Mucocutaneous Lymph Node Syndrome (MLNS) in an Infant

PEDIATRICS ◽

10.1542/peds.54.3.277 ◽

1974 ◽

Vol 54 (3) ◽

pp. 277-281

Author(s):

Masayoshi Yanagisawa ◽

Noboru Kobayashi ◽

Shoji Matsuya

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Congestive Heart Failure ◽

Lymph Node ◽

Coronary Arteries ◽

Mucocutaneous Lymph Node Syndrome ◽

Laboratory Findings ◽

Cervical Lymph Nodes ◽

Autopsy Findings ◽

Lymph Node Syndrome

A previously healthy 6-month-old male infant was admitted to our clinic for persistent high fever and an erythematous skin rash. Hyperemia of conjunctivae, redness of oral mucosa, and swelling of several cervical lymph nodes were also observed. Soon after admission he developed jaundice which continued for one week. Results of laboratory examinations revealed leukocytosis, elevated ESR, mild proteinuria, leukocytes in urinary sediment, hyperbilirubinemia, increased serum alpha-2-globulin and positive CRP. Serum ASO titer was less than 100 Todd units and complement fixation reactions for various viruses were not significant. Cultures of blood, urine, stool and throat were negative. He was treated with antibiotics and steroids and improved gradually, but then developed signs and symptoms of congestive heart failure. An ECG showed a pattern of extensive myocardial infarction. He died of congestive heart failure at the age of 21 months. Autopsy findings revealed focal aneurysmal dilatation and obstruction of the bilateral coronary arteries. The myocardial infarction involved the septum of the anterolateral wall of the left ventricle. The coronary arteries, distal aorta, iliac arteries and pulmonary arteries were also involved, but very slightly. The symptoms, laboratory findings and the course of this patient were compatible with those of acute febrile mucocutaneous lymph node syndrome (MLNS), MLNS has been accepted as a new syndrome by most Japanese pediatricians in recent years. Its etiology is still unknown. Some of the patients with this syndrome had died suddenly of coronary thromboarteritis after recovering from the acute illness. Although autopsy findings of the fatal cases have been similar to those describing infantile polyarteritis nodosa, the relationship between MLNS and infantile polyarteritis is controversial.

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