Garrido-García Luis Martín, Peña-Juárez Rocío Alejandra, Yamazaki-Nakashimada Marco Antonio
Servicio de Cardiología, Instituto Nacional de Pediatría, SSA, Ciudad de México, México.
Cardiología Pediátrica, Hospital General de Occidente, SSA, Guadalajara, Jalisco, México.
Arch Cardiol Mex. 2018 Dec;88(5):441-446. doi: 10.1016/j.acmx.2018.03.005. Epub 2018 Apr 9.
To describe the cardiac manifestations in the acute phase of patients with Kawasaki disease treated in a third level Children's hospital in Mexico City, Mexico.
A cross-sectional study was conducted in patients with a diagnosis of Kawasaki disease treated in this hospital from August 1995 to December 2016. Information included patient demographics, clinical features, treatment used, electrocardiographic findings, extra-coronary echocardiographic findings, and the development of coronary artery aneurysms in the acute phase of the disease.
The study included 508 cases of Kawasaki disease, with a mean age at diagnosis of 37.64±35.56 months (range from 2 to 200 months). Almost two-thirds (65.4%) of the patients were male, with a male/female ratio of 1.88:1. Complete Kawasaki disease was diagnosed in 79.2% of cases. Almost all cases (92.4%) received intravenous immunoglobulin. Twenty-eight patients (5.5%) developed arrhythmias, ST changes developed in 29 patients (5.6%), and 5 patients presented with ischaemic changes. In the initial echocardiographic evaluation, 51 patients (9.9%) were diagnosed with myocarditis, 72 patients (14.0%) with pericarditis and 77 cases (15.0%) developed pericardial effusion. Coronary artery anomalies were detected in 169 cases (32.9%). 32 cases were diagnosed as giant coronary aneurysms. Four patients died from cardiac complications in the acute phase of the disease.
There has been an increase in the diagnosis of Kawasaki disease in Mexico. They presented with more cardiac complications than reported in literature. An increased knowledge of Kawasaki disease is required in Mexico in order to establish the cardiac outcomes of this group of patients.
描述在墨西哥城一家三级儿童医院接受治疗的川崎病患者急性期的心脏表现。
对1995年8月至2016年12月在本院诊断为川崎病的患者进行横断面研究。信息包括患者人口统计学、临床特征、所用治疗方法、心电图检查结果、冠状动脉外超声心动图检查结果以及疾病急性期冠状动脉瘤的发生情况。
该研究纳入508例川崎病患者，诊断时的平均年龄为37.64±35.56个月（范围为2至200个月）。近三分之二（65.4%）的患者为男性，男女比例为1.88:1。79.2%的病例被诊断为完全性川崎病。几乎所有病例（92.4%）接受了静脉注射免疫球蛋白治疗。28例患者（5.5%）出现心律失常，29例患者（5.6%）出现ST段改变，5例患者出现缺血性改变。在初始超声心动图评估中，51例患者（9.9%）被诊断为心肌炎，72例患者（14.0%）被诊断为心包炎，77例患者（15.0%）出现心包积液。169例患者（32.9%）检测到冠状动脉异常。32例被诊断为巨大冠状动脉瘤。4例患者在疾病急性期死于心脏并发症。
墨西哥川崎病的诊断有所增加。他们出现的心脏并发症比文献报道的更多。墨西哥需要提高对川崎病的认识，以便确定这组患者的心脏结局。
