Tsuda Etsuko, Negishi Jun, Miike Hikari, Kurosaki Kenichi
Department of Pediatric Cardiology,National Cerebral and Cardiovascular Center,Osaka,Japan.
Cardiol Young. 2019 Jan;29(1):30-35. doi: 10.1017/S1047951118001646. Epub 2018 Oct 26.
Severe valvulitis owing to acute Kawasaki disease leading to severe mitral regurgitation is a rare event in infants. Further, there is less information about underlying ruptured mitral chordae tendineae causing severe mitral regurgitation. We encountered ruptured mitral chordae tendineae in three female patients after Kawasaki disease. The age at the onset of Kawasaki disease ranged from 3 to 8 months, and detection of ruptured mitral chordae tendineae was from 24 to 90 days. Two patients had acute heart failure, and one was asymptomatic. One patient underwent mitral annuloplasty, and the others responded to medication. These ruptured mitral chordae tendineae occurred after the remission of the initial acute Kawasaki disease, in the early course and the convalescent of acute Kawasaki disease. Further, the recurrent fever was also detected in them. The ruptured mitral chordae tendineae in an infant within 6 months can be detected by systolic heart murmur around the convalescent stage of acute Kawasaki disease, although the prevalence is very low.
急性川崎病导致严重瓣膜炎症进而引发严重二尖瓣反流在婴儿中是罕见事件。此外，关于潜在的二尖瓣腱索断裂导致严重二尖瓣反流的信息较少。我们在三名川崎病后的女性患者中遇到了二尖瓣腱索断裂的情况。川崎病发病年龄在3至8个月之间，二尖瓣腱索断裂的发现时间为24至90天。两名患者出现急性心力衰竭，一名患者无症状。一名患者接受了二尖瓣环成形术，其他患者对药物治疗有反应。这些二尖瓣腱索断裂发生在最初急性川崎病缓解后，处于急性川崎病的早期病程和恢复期。此外，在这些患者中还检测到了反复发热。6个月内婴儿的二尖瓣腱索断裂可在急性川崎病恢复期通过收缩期心脏杂音检测到，尽管其发生率非常低。
