R Martos1, S Walsh, C McCreery, J D Dodd. 1. Cardiac CT/MRI Program, Department of Cardiology, St. Vincent's University Hospital, Dublin, Ireland. ramonmartos2003@yahoo.co.uk
Abstract
BACKGROUND: Kawasaki disease is a small-to-medium-vessel vasculitis that preferentially affects infants and young children. This condition is rare in adults, and therefore the diagnosis can easily be missed in a patient presenting to a primary care clinic. We report an unusual case of a patient who presented with ventricular fibrillation on a background of adult Kawasaki disease. OBJECTIVES: To identify the advantages of using coronary multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging (MRI) in diagnosing adult Kawasaki disease. METHODS: We studied a 52-year-old patient with Kawasaki disease using coronary angiography, cardiac MDCT and MRI. RESULTS: Invasive coronary angiography demonstrated an occluded right coronary artery (RCA) and appearances suspicious for a calcified giant RCA aneurysm. The full extent of the aneurismal RCA was depicted with MDCT. Cardiac MRI revealed a chronic inferior segment myocardial infarction representing an arrhythmia substrate. DISCUSSION: Our case highlights the increasing utility of contrast-enhanced cardiac MRI and MDCT in the diagnosis of this rare condition in adults.
BACKGROUND:Kawasaki disease is a small-to-medium-vessel vasculitis that preferentially affects infants and young children. This condition is rare in adults, and therefore the diagnosis can easily be missed in a patient presenting to a primary care clinic. We report an unusual case of a patient who presented with ventricular fibrillation on a background of adult Kawasaki disease. OBJECTIVES: To identify the advantages of using coronary multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging (MRI) in diagnosing adult Kawasaki disease. METHODS: We studied a 52-year-old patient with Kawasaki disease using coronary angiography, cardiac MDCT and MRI. RESULTS: Invasive coronary angiography demonstrated an occluded right coronary artery (RCA) and appearances suspicious for a calcified giant RCA aneurysm. The full extent of the aneurismal RCA was depicted with MDCT. Cardiac MRI revealed a chronic inferior segment myocardial infarction representing an arrhythmia substrate. DISCUSSION: Our case highlights the increasing utility of contrast-enhanced cardiac MRI and MDCT in the diagnosis of this rare condition in adults.
Authors: Jane W Newburger; Masato Takahashi; Michael A Gerber; Michael H Gewitz; Lloyd Y Tani; Jane C Burns; Stanford T Shulman; Ann F Bolger; Patricia Ferrieri; Robert S Baltimore; Walter R Wilson; Larry M Baddour; Matthew E Levison; Thomas J Pallasch; Donald A Falace; Kathryn A Taubert Journal: Circulation Date: 2004-10-26 Impact factor: 29.690
Authors: Maureen Lynch; Robert C Holman; Aisling Mulligan; Ermias D Belay; Lawrence B Schonberger Journal: Pediatr Infect Dis J Date: 2003-11 Impact factor: 2.129