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Pregnancy and breast cancer in a patient with complicated Kawasaki Disease, as if one problem was not enough: a case report
BACKGROUND: Due to the increasing prevalence of Kawasaki Disease (KD) in adulthood, the number of women considering pregnancy is growing. There are limited data on the course of pregnancy in KD with coronary artery involvement. CASE SUMMARY: We report on the pregnancy outcome of a 30-year-old woman...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9704422/ https://www.ncbi.nlm.nih.gov/pubmed/36451807 http://dx.doi.org/10.1093/ehjcr/ytac435 |
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author | Barzen, Gina Stangl, Karl Blohmer, Jens-Uwe Henrich, Wolfgang Dörner, Thomas Lembcke, Alexander Stangl, Verena |
author_facet | Barzen, Gina Stangl, Karl Blohmer, Jens-Uwe Henrich, Wolfgang Dörner, Thomas Lembcke, Alexander Stangl, Verena |
author_sort | Barzen, Gina |
collection | PubMed |
description | BACKGROUND: Due to the increasing prevalence of Kawasaki Disease (KD) in adulthood, the number of women considering pregnancy is growing. There are limited data on the course of pregnancy in KD with coronary artery involvement. CASE SUMMARY: We report on the pregnancy outcome of a 30-year-old woman with KD who was successfully resuscitated for ventricular tachycardia 3 years before. At that time, bypass surgery and later implantable cardioverter-defibrillator implantation were performed because of thrombotically occluded calcified giant coronary aneurysms. The pregnancy course was initially uncomplicated, however, at 31 weeks of gestation, left-sided breast cancer was diagnosed. Weighing maximum therapeutic efficacy against acceptable foetal and maternal cardiotoxic risk, our multidisciplinary team decided on neoadjuvant chemotherapy. The mother and foetus tolerated the therapy well. However, at 36 weeks of gestation, due to HELLP (haemolysis, elevated liver, low platelets) syndrome, a caesarean section had to be performed. The newborn was healthy with good APGAR (appearance, pulse, grimace, activity, respiration) scores. Three weeks after delivery, chemotherapy was restarted and at Week 4 after the caesarean section, the tumour was no more detectable. DISCUSSION: We discuss data on pregnancy and KD and outline that pregnancy can be considered if the clinical condition is good and left ventricular function is preserved. We also address possible therapeutic approaches and care for breast cancer in pregnancy and coexisting cardiovascular disease. The extraordinary importance of interdisciplinary cooperation between different disciplines in such complex clinical disease conditions is emphasized. |
format | Online Article Text |
id | pubmed-9704422 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-97044222022-11-29 Pregnancy and breast cancer in a patient with complicated Kawasaki Disease, as if one problem was not enough: a case report Barzen, Gina Stangl, Karl Blohmer, Jens-Uwe Henrich, Wolfgang Dörner, Thomas Lembcke, Alexander Stangl, Verena Eur Heart J Case Rep Grand Round BACKGROUND: Due to the increasing prevalence of Kawasaki Disease (KD) in adulthood, the number of women considering pregnancy is growing. There are limited data on the course of pregnancy in KD with coronary artery involvement. CASE SUMMARY: We report on the pregnancy outcome of a 30-year-old woman with KD who was successfully resuscitated for ventricular tachycardia 3 years before. At that time, bypass surgery and later implantable cardioverter-defibrillator implantation were performed because of thrombotically occluded calcified giant coronary aneurysms. The pregnancy course was initially uncomplicated, however, at 31 weeks of gestation, left-sided breast cancer was diagnosed. Weighing maximum therapeutic efficacy against acceptable foetal and maternal cardiotoxic risk, our multidisciplinary team decided on neoadjuvant chemotherapy. The mother and foetus tolerated the therapy well. However, at 36 weeks of gestation, due to HELLP (haemolysis, elevated liver, low platelets) syndrome, a caesarean section had to be performed. The newborn was healthy with good APGAR (appearance, pulse, grimace, activity, respiration) scores. Three weeks after delivery, chemotherapy was restarted and at Week 4 after the caesarean section, the tumour was no more detectable. DISCUSSION: We discuss data on pregnancy and KD and outline that pregnancy can be considered if the clinical condition is good and left ventricular function is preserved. We also address possible therapeutic approaches and care for breast cancer in pregnancy and coexisting cardiovascular disease. The extraordinary importance of interdisciplinary cooperation between different disciplines in such complex clinical disease conditions is emphasized. Oxford University Press 2022-11-05 /pmc/articles/PMC9704422/ /pubmed/36451807 http://dx.doi.org/10.1093/ehjcr/ytac435 Text en © The Author(s) 2022. 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 | Grand Round Barzen, Gina Stangl, Karl Blohmer, Jens-Uwe Henrich, Wolfgang Dörner, Thomas Lembcke, Alexander Stangl, Verena Pregnancy and breast cancer in a patient with complicated Kawasaki Disease, as if one problem was not enough: a case report |
title | Pregnancy and breast cancer in a patient with complicated Kawasaki Disease, as if one problem was not enough: a case report |
title_full | Pregnancy and breast cancer in a patient with complicated Kawasaki Disease, as if one problem was not enough: a case report |
title_fullStr | Pregnancy and breast cancer in a patient with complicated Kawasaki Disease, as if one problem was not enough: a case report |
title_full_unstemmed | Pregnancy and breast cancer in a patient with complicated Kawasaki Disease, as if one problem was not enough: a case report |
title_short | Pregnancy and breast cancer in a patient with complicated Kawasaki Disease, as if one problem was not enough: a case report |
title_sort | pregnancy and breast cancer in a patient with complicated kawasaki disease, as if one problem was not enough: a case report |
topic | Grand Round |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9704422/ https://www.ncbi.nlm.nih.gov/pubmed/36451807 http://dx.doi.org/10.1093/ehjcr/ytac435 |
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