Successful thrombolytic therapy using tissue-type plasminogen activator in Kawasaki disease
Thrombolytic therapy using tissue-type plasminogen activator was performed in a 7-month-old boy with massive mural thrombi in large coronary aneurysms due to Kawasaki disease. Magnetic resonance imaging successfully demonstrated mural thrombi in both proximal and distal coronary aneurysms and their disappearance after thrombolytic therapy. We conclude that for preventing acute myocardial infarction and sudden death intravenous and intracoronary thrombolytic therapy with tissue-type plasminogen activator may help in infants and children with Kawasaki disease who have thrombi in coronary aneurysms.
Key wordsKawasaki disease Ischemic heart disease Tissue-type plasminogen activator Thrombolytic therapy
Unable to display preview. Download preview PDF.
- 1.ACC/AHA Task Force (1990) ACC/AHA guideline for the early management of patients with acute myocardial infarction.Circulation 82:664–707Google Scholar
- 2.Bisset GS III, Strife JL, McCloskey J (1989) MR imaging of coronary artery aneurysms in a child with Kawasaki disease.AJR 152:805–807Google Scholar
- 3.Blackwell GG, Cranney GB, Pohost GM (1992) Disease of the aorta: acquired aortic disease. In: Blackwell GG, Cranney GB, Pohost GM (eds)MRI: Cardiovascular System. Gower, New York, pp 12.7–12.21Google Scholar
- 4.Burtt DM, Pollack P, Bianco JA (1986) Intravenous streptokinase in an infant with Kawasaki's disease complicated by acute myocardial infarction.Pediatr Cardiol 6:307–311Google Scholar
- 5.Freeman MR, Langer A, Wilson RF, Morgan CD, Armstrong PW (1992) Thrombolysis in unstable angina: randomized double-blind trial of t-PA and placebo.Circulation 85:150–157Google Scholar
- 6.Kato H, Inoue O, Ichinose E, Akagi T, Sato N (1991) Intracoronary urokinase in Kawasaki disease: treatment and prevention of myocardial infarction.Acta Paediatr Jpn 33:27–35Google Scholar
- 7.Nakamura Y, Yanagawa H, Kawasaki T (1992) Mortality among children with Kawasaki disease in Japan.N Engl J Med 326:1246–1249Google Scholar
- 8.Suzuki A, Kamiya T, Ono Y, Kinoshita Y (1993) Thrombolysis in the treatment of patients with Kawasaki disease.Cardiol Young 3:207–215Google Scholar
- 9.Suzuki A, Kamiya T, Ono Y, Kohata T, Okuno M (1988) Myocardial ischemia in Kawasaki disease: follow-up study by cardiac catheterization and coronary angiography.Pediatr Cardiol 9:1–5Google Scholar
- 10.Terai M, Ogata M, Sugimoto K, et al (1985) Coronary arterial thrombi in Kawasaki disease.J Pediatr 106:76–78Google Scholar
- 11.Wasserman AG, Ross AM (1989) Patient selection for thrombolytic therapy.Am J Cardiol 64:17B-21BGoogle Scholar
- 12.White RD, Winkler ML, Higgins CB (1987) MR imaging of pulmonary artery hypertension and pulmonary emboli.AJR 149:15–21Google Scholar