Kato H, Ichinose E, Kawasaki T
J Pediatr. 1986 Jun;108(6):923-7. doi: 10.1016/s0022-3476(86)80928-3.
We analyzed clinical data from 195 patients (141 boys) with myocardial infarction complicating Kawasaki disease, collected from 74 major hospitals in Japan. The myocardial infarction usually occurred within the first year of illness, but 27.2% of the patients had myocardial infarction more than 1 year later. In 63% of the patients it occurred during sleep or at rest. The main symptoms of acute myocardial infarction were shock, unrest, vomiting, abdominal pain, and chest pain; chest pain was much more frequently recognized in the survivors and in older patients. The myocardial infarctions were asymptomatic in 37% of the patients. Twenty-two percent of the patients died during the first attack. Sixteen percent of the survivors of a first attack had a second attack. Forty-three percent of all survivors of the first or subsequent attack are doing well; however, others have some type of cardiac dysfunction, such as mitral regurgitation, decreased ejection fraction of the left ventricle, or left ventricular aneurysm. Coronary angiographic studies indicate that in most of the fatal cases there was obstruction either in the main left coronary artery or in both the main right coronary artery and the anterior descending artery. In survivors, one-vessel obstruction was frequently recognized, particularly in the right coronary artery.
我们分析了从日本74家主要医院收集的195例川崎病并发心肌梗死患者（141名男孩）的临床数据。心肌梗死通常发生在发病的第一年，但27.2%的患者在1年多后发生心肌梗死。63%的患者在睡眠或休息时发生。急性心肌梗死的主要症状为休克、烦躁不安、呕吐、腹痛和胸痛；幸存者和老年患者中胸痛的发生率更高。37%的患者心肌梗死无症状。22%的患者在首次发作时死亡。首次发作的幸存者中有16%发生第二次发作。首次或后续发作的所有幸存者中有43%情况良好；然而，其他患者有某种类型的心脏功能障碍，如二尖瓣反流、左心室射血分数降低或左心室动脉瘤。冠状动脉造影研究表明，在大多数致命病例中，左冠状动脉主干或右冠状动脉主干及前降支均有阻塞。在幸存者中，单支血管阻塞很常见，尤其是在右冠状动脉。
