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Two females with coronary artery occlusion caused by presumed Kawasaki disease would have delivered without recognition of ischaemic heart disease

Published online by Cambridge University Press:  08 May 2020

Etsuko Tsuda Open the ORCID record for Etsuko Tsuda [Opens in a new window] ,
Takashi Noda  and
Teruo Noguchi
Etsuko Tsuda*
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Takashi Noda
Affiliation:
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
Teruo Noguchi
Affiliation:
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
*
Author for correspondence: Etsuko Tsuda, Department of Pediatric cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan. Tel: +81 06 6170 1070; Fax: +81 06 6170 1782. E-mail: etsuda@ncvc.go.jp
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Abstract

We report two females with coronary artery occlusion caused by presumed Kawasaki disease that delivered children without any special treatment. After a 58-year-old female had ventricular tachycardia, a giant coronary artery aneurysm with calcification at the bifurcation of the left coronary artery and segmental stenosis of the right coronary artery were pointed out by CT angiography. She had an episode of sepsis when 3 years old. Further, she remembered chest pain during sleep after that episode. She had delivered twice without any complication during her 20s. Her diagnosis was undiagnosed coronary artery lesions caused by presumed Kawasaki disease and a previous myocardial infarction, and she underwent radiofrequency catheter ablation and implantable cardioverter defibrillator implantation. The other 48-year-old female was accidentally discovered to have coronary artery calcification on CT, while experiencing pneumonia. Her CT angiograms revealed a right coronary artery occlusion and coronary artery calcification at segments 1, 6, and 11. She had a history of “scarlet fever” before 12 months. Premature ventricular contractions were detected, while delivering her first child when 31 years old. However, she was not diagnosed as ischaemic heart disease and delivered twice by a vaginal delivery without any complication. Current guidelines recommend systemic anti-coagulation and anti-platelet therapy for all patients with giant aneurysms resulting from Kawasaki disease in childhood. The two women reported here were fortunate not to have had complications during pregnancy and delivery despite their severe coronary artery aneurysms, which were unrecognised clinically until later in life. They were lucky cases.

Keywords

Kawasaki diseasecoronary artery occlusioncoronary artery calcificationventricular tachycardiadeliverycoronary artery aneurysm
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 6 , June 2020 , pp. 785 - 789
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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