Dipyridamole-induced ischemia in a child with jeopardized collaterals after Kawasaki syndrome.
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概要
- 論文の詳細を見る
The case of a 4-year-old boy with dipyridamole-induced ischemia is herein reported. The patient developed typical Kawasaki syndrome at 2 years of age, accompanied by coronary aneurysms in the left coronary artery (LCA) and the right coronary artery (RCA). The LCA was totally occluded at segment 6 and a distal area of the left anterior descending artery (LAD) was supplied by collaterals from the conus branch and the posterior descending artery (PD). Thallium-201 (T1-201) myocardial scintigraphy was performed with intravenous administration of dipyridamole (DIP). DIP was infused at a dosage of 0.6mg/kg for 5min. Three minutes after the injection, myocardial ischemia occurred. Although 4mg/kg of aminophyllin was administered, the symptoms lasted for 20min. Electrocardiogram suggested that ischemic lesions were located in the anteroseptal and inferior wall. Collaterals from PD could be recognized as jeopardized vessels and these collaterals probably participated in the ischemic attack. DIP could have increased the coronary flow into the uninvolved proximal branches of RCA. Subsequently DIP reduced coronary flow in the distal region of the stenotic RCA. Although T1-201 myocardial scintigraphy with DIP is a useful technique to estimate viability of the ischemic myocardium, it should be performed prudently in patients with multivessel diseases, such as those with jeopardized collaterals secondary to Kawasaki syndrome.
- International Heart Journal刊行会の論文
著者
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Matsuura Hiroyuki
Department Of Advanced Materials Science Graduate School Of Frontier Sciences The University Of Toky
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Umezawa Tetsuro
Department of Pediatrics, TOHO University, School of Medicine
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Yabe Yoshimasa
Department Of Cardiology Juntendo University School Of Medicine And Department Of Laboratory Medicin
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Yamamoto Shin
Department Of Cardiothoracic Surgery Juntendo University School Of Medicine
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Saji Tsutomu
Department Of First Department Of Pediatrics Toho University Omori Medical Center
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MATSUO Norio
Department of Pediatric Cardiology, National Children's Hospital
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YABE Yoshimasa
Department of Cardiovascular Diagnostic Laboratory Center, Toho University, School of Medicine
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YAMAMOTO Shin
Department of Pediatrics, Toho University, School of Medicine
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