[Myocardial Infarction and resuscitation of an adolescent: consequences of an unexplained disease]. / Myocardinfarct en reanimatie bij een adolescent.

ABSTRACT

BACKGROUND: Morbus Kawasaki is defined by unexplained fever combined with at least 4 out of 5 classic symptoms bilateral conjunctivitis, polymorphic exanthema, strawberry tongue and red swollen lips, extremity changes and cervical lymphadenopathy. However, these symptoms do not always occur completely or simultaneously. CASE DESCRIPTION An 18-year old man was admitted after an out of hospital cardiac arrest caused by an occluded aneurysmatic LAD, which was treated with a percutanious coronary intervention. Coronary angiogram however also revealed coronary aneurysms of all coronaries, identifying an episode of unexplained fever and vasculitis 4 years prior as Morbus Kawasaki. CONCLUSION: Echocardiogram, CTA and MRA can reveal coronary malformations and thus identify M. Kawasaki when there is an incomplete M. Kawasaki. An early diagnosis and treatment with high dose aspirin and intravenous immunoglobulines is essential to reduce the risk of cardiovascular complications later in life.