Infarto agudo do miocárdio silencioso associado a aneurisma de artéria coronária decorrente de doença de Kawasaki: relato de caso / Silent acute myocardial infarction associated with coronary artery aneurysm due to Kawasaki disease: case report
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Abstract
A doença de Kawasaki é caracterizada por uma vasculite aguda sistêmica que ocorre na grande maioria dos casos em crianças menores de cinco anos de idade. A doença tem curso autolimitado e tratamento baseado no uso de imunoglobulina intravenosa e salicilatos. A principal gravidade se dá pelas possíveis complicações, sendo a mais grave a formação de aneurismas de artérias coronárias. O presente trabalho visa relatar o caso de uma paciente que não recebeu o diagnóstico de doença de Kawasaki na infância. Na vida adulta, durante ecocardiograma diagnosticou-se uma hipocinesia de parede inferior e parte distal do septo inferior. Em posterior angiografia, verificou-se artéria coronária direita ectásica em toda a sua extensão. Trata-se de um caso raro devido à formação de aneurismas coronarianos não tratados, após anos de doença, e sua manifestação isquêmica.
Palavras-Chave: Síndrome de linfonodos mucocutâneos; Doença das coronárias; Infarto do miocárdio
ABSTRACT
Kawasaki disease is characterized by the presence of acute systemic vasculitis that occurs in most of cases in children under five years of age. The disease has an auto-limited path and the treatment is based on intravenous immunoglobulin and salicylates. The main gravity is due to the possible complications, and the most serious is the formation of coronary artery aneurysms. The present work aims to report the case of a patient, who did not receive the diagnosis of Kawasaki disease in childhood. In adulthood, an inferior wall hypokinesia and a distal part of the inferior septum were diagnosed by echocardiogram. In a subsequent angiography it was verified a ectasia right coronary artery throughout its extension. This is a rare case due to the formation of untreated coronary aneurysms after years of illness associated with ischemic manifestations.
Keywords: Mucocutaneous lymph node syndrome; Myocardial infarction; Coronary disease
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