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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...

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Autores principales: Barzen, Gina, Stangl, Karl, Blohmer, Jens-Uwe, Henrich, Wolfgang, Dörner, Thomas, Lembcke, Alexander, Stangl, Verena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
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.
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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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