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Multimodal imaging for cardiac follow-up and management of giant coronary aneurysm related to Kawasaki disease in childhood: a case report

BACKGROUND: Kawasaki disease (KD) is a rare paediatric condition that can lead to giant coronary aneurysms. Follow-up of such complex coronary lesions remains a challenge, and their management is difficult to standardize. CASE SUMMARY: Our present case concerns a 17-year-old boy who suffered a giant...

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Autores principales: Werner, Oscar, Pommier, Victor, Guillaumont, Sophie, Vincenti, Marie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588614/
https://www.ncbi.nlm.nih.gov/pubmed/37869738
http://dx.doi.org/10.1093/ehjcr/ytad495
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author Werner, Oscar
Pommier, Victor
Guillaumont, Sophie
Vincenti, Marie
author_facet Werner, Oscar
Pommier, Victor
Guillaumont, Sophie
Vincenti, Marie
author_sort Werner, Oscar
collection PubMed
description BACKGROUND: Kawasaki disease (KD) is a rare paediatric condition that can lead to giant coronary aneurysms. Follow-up of such complex coronary lesions remains a challenge, and their management is difficult to standardize. CASE SUMMARY: Our present case concerns a 17-year-old boy who suffered a giant aneurysm of the left coronary artery, complicated by an asymptomatic stenosis. During regular follow-up, his annual cardiopulmonary exercise test revealed signs of ischaemia (ST depression and premature ventricular complexes). After several further stress tests with inconsistent results, he underwent invasive coronary angiography that revealed significant stenosis with a positive fractional flow reserve (FFR). DISCUSSION: We discuss the challenges of diagnosing and managing coronary artery stenosis in paediatric patients with KD, particularly in cases with calcified and thrombosed lesions. A multimodal approach is crucial, including non-invasive imaging, and coronary angiography with optical coherence tomography and FFR. The evaluation of the lesion and its follow-up is an important factor in anticipating the best therapeutic choice for each patient.
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spelling pubmed-105886142023-10-21 Multimodal imaging for cardiac follow-up and management of giant coronary aneurysm related to Kawasaki disease in childhood: a case report Werner, Oscar Pommier, Victor Guillaumont, Sophie Vincenti, Marie Eur Heart J Case Rep Case Report BACKGROUND: Kawasaki disease (KD) is a rare paediatric condition that can lead to giant coronary aneurysms. Follow-up of such complex coronary lesions remains a challenge, and their management is difficult to standardize. CASE SUMMARY: Our present case concerns a 17-year-old boy who suffered a giant aneurysm of the left coronary artery, complicated by an asymptomatic stenosis. During regular follow-up, his annual cardiopulmonary exercise test revealed signs of ischaemia (ST depression and premature ventricular complexes). After several further stress tests with inconsistent results, he underwent invasive coronary angiography that revealed significant stenosis with a positive fractional flow reserve (FFR). DISCUSSION: We discuss the challenges of diagnosing and managing coronary artery stenosis in paediatric patients with KD, particularly in cases with calcified and thrombosed lesions. A multimodal approach is crucial, including non-invasive imaging, and coronary angiography with optical coherence tomography and FFR. The evaluation of the lesion and its follow-up is an important factor in anticipating the best therapeutic choice for each patient. Oxford University Press 2023-10-09 /pmc/articles/PMC10588614/ /pubmed/37869738 http://dx.doi.org/10.1093/ehjcr/ytad495 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Werner, Oscar
Pommier, Victor
Guillaumont, Sophie
Vincenti, Marie
Multimodal imaging for cardiac follow-up and management of giant coronary aneurysm related to Kawasaki disease in childhood: a case report
title Multimodal imaging for cardiac follow-up and management of giant coronary aneurysm related to Kawasaki disease in childhood: a case report
title_full Multimodal imaging for cardiac follow-up and management of giant coronary aneurysm related to Kawasaki disease in childhood: a case report
title_fullStr Multimodal imaging for cardiac follow-up and management of giant coronary aneurysm related to Kawasaki disease in childhood: a case report
title_full_unstemmed Multimodal imaging for cardiac follow-up and management of giant coronary aneurysm related to Kawasaki disease in childhood: a case report
title_short Multimodal imaging for cardiac follow-up and management of giant coronary aneurysm related to Kawasaki disease in childhood: a case report
title_sort multimodal imaging for cardiac follow-up and management of giant coronary aneurysm related to kawasaki disease in childhood: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588614/
https://www.ncbi.nlm.nih.gov/pubmed/37869738
http://dx.doi.org/10.1093/ehjcr/ytad495
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