Pub Date : 2021-07-31DOI: 10.23937/2643-3966/1710041
Paterick Timothy
This manuscript explores the clinical presentation and physical examination findings in pregnant patients with presumed heart disease. There is a review of the clinical presentation, physical examination, and multi-modality imaging that led to a diagnosis in pregnant patients with coronary artery disease, cardiomyopathies, arrhythmias, valvular heart disease, and pulmonary hypertension. The cases are not exhaustive, but represent a subset of the large number of cardiovascular conditions affecting pregnant patients. For an excellent and exhaustive review, the readership is directed to the 2018 ESC Guidelines for the management of cardiovascular disease during pregnancy.
{"title":"Cardiovascular Urgencies and Emergencies in Pregnancy: A Case Based Review of Some Cardiovascular Diseases Affecting Pregnant Females","authors":"Paterick Timothy","doi":"10.23937/2643-3966/1710041","DOIUrl":"https://doi.org/10.23937/2643-3966/1710041","url":null,"abstract":"This manuscript explores the clinical presentation and physical examination findings in pregnant patients with presumed heart disease. There is a review of the clinical presentation, physical examination, and multi-modality imaging that led to a diagnosis in pregnant patients with coronary artery disease, cardiomyopathies, arrhythmias, valvular heart disease, and pulmonary hypertension. The cases are not exhaustive, but represent a subset of the large number of cardiovascular conditions affecting pregnant patients. For an excellent and exhaustive review, the readership is directed to the 2018 ESC Guidelines for the management of cardiovascular disease during pregnancy.","PeriodicalId":170730,"journal":{"name":"International Archives of Cardiovascular Diseases","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128336507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-03DOI: 10.23937/2643-3966/1710040
Khan Muhammad Zubair, F. Sona, Hyman Richard
A Percutaneous assist device is commonly used in cardiogenic shock to improve hemodynamics. The Impella provided superior hemodynamic support in the ISARSHOCK study compared with an intra-aortic balloon pump (IABP), with no change in clinical outcome. In this trial, the IABP was used in one group, and the Impella was placed in a comparator group. We present a case in which the hemodynamics of cardiogenic shock was assessed in the same patient after IABP and after Impella placement. In our case, the hemodynamics improved after Impella placement and removal of IABP. *Corresponding author: Richard Hyman, MD, Department of Medicine, St. Mary Medical Center, 1201 NewtownLanghorne Rd, Langhorne, PA 19047, USA, Tel: +1-215-750-7000 Check for updates
经皮辅助装置常用于心源性休克以改善血流动力学。在ISARSHOCK研究中,与主动脉内球囊泵(IABP)相比,Impella提供了更好的血流动力学支持,临床结果没有变化。在本试验中,IABP作为一组,Impella作为对照组。我们提出了一个病例,在IABP和Impella放置后,对同一患者的心源性休克的血流动力学进行了评估。在我们的病例中,在植入和移除IABP后,血流动力学得到改善。*通讯作者:Richard Hyman,医学博士,圣玛丽医疗中心医学系,1201 NewtownLanghorne Rd, Langhorne, PA 19047, USA, Tel: +1-215-750-7000查看最新情况
{"title":"Impella Device is Superior to an Intra-Aortic Balloon Pump in Cardiogenic Shock","authors":"Khan Muhammad Zubair, F. Sona, Hyman Richard","doi":"10.23937/2643-3966/1710040","DOIUrl":"https://doi.org/10.23937/2643-3966/1710040","url":null,"abstract":"A Percutaneous assist device is commonly used in cardiogenic shock to improve hemodynamics. The Impella provided superior hemodynamic support in the ISARSHOCK study compared with an intra-aortic balloon pump (IABP), with no change in clinical outcome. In this trial, the IABP was used in one group, and the Impella was placed in a comparator group. We present a case in which the hemodynamics of cardiogenic shock was assessed in the same patient after IABP and after Impella placement. In our case, the hemodynamics improved after Impella placement and removal of IABP. *Corresponding author: Richard Hyman, MD, Department of Medicine, St. Mary Medical Center, 1201 NewtownLanghorne Rd, Langhorne, PA 19047, USA, Tel: +1-215-750-7000 Check for updates","PeriodicalId":170730,"journal":{"name":"International Archives of Cardiovascular Diseases","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125947047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-31DOI: 10.23937/2643-3966/1710038
Stelzmueller Marie-Elisabeth, Mora Bruno, Laufer Guenther, Wisser Wilfried
{"title":"Technical Feasibility Does Not Guarantee Clinical Improvement: A Word of Caution for Valve-in-Valve Procedures in Small Surgical Prosthesis","authors":"Stelzmueller Marie-Elisabeth, Mora Bruno, Laufer Guenther, Wisser Wilfried","doi":"10.23937/2643-3966/1710038","DOIUrl":"https://doi.org/10.23937/2643-3966/1710038","url":null,"abstract":"","PeriodicalId":170730,"journal":{"name":"International Archives of Cardiovascular Diseases","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121065340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-31DOI: 10.23937/2643-3966/1710039
J. VillasmilRicardo, J. LorenzoChristian, K. AbdelalQassem, I. ConteJorge, Lattanzio Natalia, Wiese-Rometsch Wilhelmine, G. ChengHenry
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been reported to cause cardiac complications including myocarditis, acute myocardial infarction (AMI) and various tachyarrhythmias. We present a 63-year-old male who developed nonreversible symptomatic bradycardia due to advanced atrioventricular block (AV) requiring pacemaker placement in the setting of severe SARS-CoV-2 pneumonia.
{"title":"Complete Heart Block in a Patient with COVID-19","authors":"J. VillasmilRicardo, J. LorenzoChristian, K. AbdelalQassem, I. ConteJorge, Lattanzio Natalia, Wiese-Rometsch Wilhelmine, G. ChengHenry","doi":"10.23937/2643-3966/1710039","DOIUrl":"https://doi.org/10.23937/2643-3966/1710039","url":null,"abstract":"The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been reported to cause cardiac complications including myocarditis, acute myocardial infarction (AMI) and various tachyarrhythmias. We present a 63-year-old male who developed nonreversible symptomatic bradycardia due to advanced atrioventricular block (AV) requiring pacemaker placement in the setting of severe SARS-CoV-2 pneumonia.","PeriodicalId":170730,"journal":{"name":"International Archives of Cardiovascular Diseases","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121835083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-23DOI: 10.23937/2643-3966/1710033
AlShamakhi Ahmed Khamis, Jamkhandikar Rakesh Malhari, AlWahshi Yahya Mohammed, P. S. Murthi
Objectives: This study aimed to assess the impact of iterative reconstruction (IR) algorithms for the evaluation of coronary artery calcification (CAC) in terms of image quality and subjective diagnostic performance. Methods: This study was performed in a single center and written informed consent was obtained from all patients. Thirty-one consecutive patients (26 men/5 women) underwent CT calcium score to rule out CAC. Image data were reconstructed with both; filtered back projection (FBP) and different levels of IR algorithms. Both the qualitative and quantitative image quality and subjective diagnostic performance were compared; Agatston scores and calcium density were measured for a total of 100 coronary arteries. Results: Quantitatively; image noise was substantially reduced with high levels of IR reflecting high significances of noise level (p < 0.001). In terms of subjective diagnostic performance, it was observed with increased IR levels; 49% of coronary arteries showed decrease, 14% showed increase, 32% were constant and 5% of coronary arteries showed fluctuation in total Agatston scores. Certain Agatston scores were not detected in coronary arteries in some levels of IR algorithms. Conclusions: IR resulted in substantial noise reduction and improved in both signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Higher levels of IR might lead to disappearance or underestimation of detectable calcium in coronary arteries with low calcium burden. Iterative reconstruction technique should be used with caution for better calcium quantification.
{"title":"The Influence of Iterative Reconstruction Technique on the Diagnosis of Coronary Artery Calcification","authors":"AlShamakhi Ahmed Khamis, Jamkhandikar Rakesh Malhari, AlWahshi Yahya Mohammed, P. S. Murthi","doi":"10.23937/2643-3966/1710033","DOIUrl":"https://doi.org/10.23937/2643-3966/1710033","url":null,"abstract":"Objectives: This study aimed to assess the impact of iterative reconstruction (IR) algorithms for the evaluation of coronary artery calcification (CAC) in terms of image quality and subjective diagnostic performance. Methods: This study was performed in a single center and written informed consent was obtained from all patients. Thirty-one consecutive patients (26 men/5 women) underwent CT calcium score to rule out CAC. Image data were reconstructed with both; filtered back projection (FBP) and different levels of IR algorithms. Both the qualitative and quantitative image quality and subjective diagnostic performance were compared; Agatston scores and calcium density were measured for a total of 100 coronary arteries. Results: Quantitatively; image noise was substantially reduced with high levels of IR reflecting high significances of noise level (p < 0.001). In terms of subjective diagnostic performance, it was observed with increased IR levels; 49% of coronary arteries showed decrease, 14% showed increase, 32% were constant and 5% of coronary arteries showed fluctuation in total Agatston scores. Certain Agatston scores were not detected in coronary arteries in some levels of IR algorithms. Conclusions: IR resulted in substantial noise reduction and improved in both signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Higher levels of IR might lead to disappearance or underestimation of detectable calcium in coronary arteries with low calcium burden. Iterative reconstruction technique should be used with caution for better calcium quantification.","PeriodicalId":170730,"journal":{"name":"International Archives of Cardiovascular Diseases","volume":"216 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131545083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-12DOI: 10.23937/2643-3966/1710032
M. Vinay, E. PaterickTimothy
Objective: A practical approach to determining risk in sedentary and active patients for coronary artery disease. Identify how personal/family history, atherogenic risk factors, and coronary calcium are essential to determining and predicting risk potential. Materials/methods: Review of the medical, behavioral psychology, and standard of care literature to identify how human psychology, statistical risk of coronary disease, and coronary calcium shape risk prediction. Results: A comprehensive personal/family history, risk factor assessment and comprehensive physical examination are the foundation of risk assessment. Understanding the cognitive process of risk potential is critical to management strategies. Stress testing and coronary calcium scoring are useful adjuncts when initial screening is suggestive of intermediate atherogenic risk. Conclusion: Comprehensive personal/family history, risk factor assessment, comprehensive physical examination, cognitive processing of risk potential, stress testing and calcium scoring all have a role in risk assessment of sedentary and active patients.
{"title":"Coronary Artery Disease Risk Assessment in Sedentary and Active Patients: Medical Risk, Behavioral Psychology, and the Standard of Care","authors":"M. Vinay, E. PaterickTimothy","doi":"10.23937/2643-3966/1710032","DOIUrl":"https://doi.org/10.23937/2643-3966/1710032","url":null,"abstract":"Objective: A practical approach to determining risk in sedentary and active patients for coronary artery disease. Identify how personal/family history, atherogenic risk factors, and coronary calcium are essential to determining and predicting risk potential. Materials/methods: Review of the medical, behavioral psychology, and standard of care literature to identify how human psychology, statistical risk of coronary disease, and coronary calcium shape risk prediction. Results: A comprehensive personal/family history, risk factor assessment and comprehensive physical examination are the foundation of risk assessment. Understanding the cognitive process of risk potential is critical to management strategies. Stress testing and coronary calcium scoring are useful adjuncts when initial screening is suggestive of intermediate atherogenic risk. Conclusion: Comprehensive personal/family history, risk factor assessment, comprehensive physical examination, cognitive processing of risk potential, stress testing and calcium scoring all have a role in risk assessment of sedentary and active patients.","PeriodicalId":170730,"journal":{"name":"International Archives of Cardiovascular Diseases","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129833031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-11DOI: 10.23937/2643-3966/1710028
Saad Moustafa Kamal Eldin Ibrahim Khalil, El-khashab Khalid A, Ragab Tamer M
Background: Adverse Left Ventricular Remodelling (LVR), defined as progressive ventricular dilatation, distortion of chamber shape, myocardial hypertrophy and deteriorating function, begins in some patients who suffered from Acute Myocardial Infarction (AMI), sometimes even after successful Percutaneous Coronary Intervention (PCI). If uninterrupted, it could lead to Congestive Heart Failure (CHF) and a poor clinical outcome. Aims: This study aims at evaluating the value of Speckle Tracking Echocardiography (STE) in predicting LVR after successful PCI in AMI patients. Materials and Methods: Eighty-four AMI patients had a complete echocardiographic study, including speckle tracking, performed two days after PCI and then two months afterwards. The patients were then divided into two groups based on the presenceh of remodelling; R+ (remodelling) group and R- (non-remodelling) group. Results: At the baseline study, group R+ showed significantly lower strain parameters than group R-. These included Global Longitudinal Strain (GLS) (-11.14 ± 0.5 VS -16.78 ± 0.4, p˂0.0001), longitudinal strain rate (-1.01 ± 0.05 VS -1.07 ± 0.04, p˂0.0001), Culprit Longitudinal Strain (CulLS) (-9.74 ± 0.59 VS -15.68 ± 0.49, P˂0.0001), and culprit longitudinal strain rate (-0.95 ± 0.05 VS -1.02 ± 0.04, P˂0.0001). In the follow up study, all of the strain parameters studied were again significantly lower in the R+ than the R- group. The most sensitive and specific parameters were the GLS and CulLS (sensitivities of 91.7% and 95.8% respectively and specificities of 95% and 96.7% respectively). Conclusion: Our findings show that impaired indices of LV deformation detected two days after successful PCI for AMI may provide a predictive value in early detection of LV remodelling.
背景:不良左心室重构(LVR),定义为进行性心室扩张,腔室形状扭曲,心肌肥厚和功能恶化,开始于一些急性心肌梗死(AMI)患者,有时甚至在经皮冠状动脉介入治疗(PCI)成功后。如果不间断,它可能导致充血性心力衰竭(CHF)和不良的临床结果。目的:本研究旨在评价斑点追踪超声心动图(STE)对AMI患者PCI术后LVR的预测价值。材料与方法:84例AMI患者在PCI术后2天和术后2个月分别进行了完整的超声心动图研究,包括斑点追踪。然后根据是否存在重构将患者分为两组;R+(重塑)组和R-(非重塑)组。结果:在基线研究中,R+组的应变参数明显低于R-组。其中包括全局纵向应变(GLS)(-11.14±0.5 VS -16.78±0.4,p小于0.0001)、纵向应变率(-1.01±0.05 VS -1.07±0.04,p小于0.0001)、罪魁祸首纵向应变(CulLS)(-9.74±0.59 VS -15.68±0.49,p小于0.0001)和罪魁祸首纵向应变率(-0.95±0.05 VS -1.02±0.04,p小于0.0001)。在后续研究中,R+组的所有应变参数均明显低于R-组。GLS和CulLS是最敏感和特异的参数,灵敏度分别为91.7%和95.8%,特异度分别为95%和96.7%。结论:我们的研究结果表明,在AMI成功PCI后两天检测到的左室变形受损指数可能对早期发现左室重构提供预测价值。
{"title":"Two Dimensional Speckle Tracking Echocardiography Assessment of Left Ventricular Remodeling in Patients after Myocardial Infarction","authors":"Saad Moustafa Kamal Eldin Ibrahim Khalil, El-khashab Khalid A, Ragab Tamer M","doi":"10.23937/2643-3966/1710028","DOIUrl":"https://doi.org/10.23937/2643-3966/1710028","url":null,"abstract":"Background: Adverse Left Ventricular Remodelling (LVR), defined as progressive ventricular dilatation, distortion of chamber shape, myocardial hypertrophy and deteriorating function, begins in some patients who suffered from Acute Myocardial Infarction (AMI), sometimes even after successful Percutaneous Coronary Intervention (PCI). If uninterrupted, it could lead to Congestive Heart Failure (CHF) and a poor clinical outcome. Aims: This study aims at evaluating the value of Speckle Tracking Echocardiography (STE) in predicting LVR after successful PCI in AMI patients. Materials and Methods: Eighty-four AMI patients had a complete echocardiographic study, including speckle tracking, performed two days after PCI and then two months afterwards. The patients were then divided into two groups based on the presenceh of remodelling; R+ (remodelling) group and R- (non-remodelling) group. Results: At the baseline study, group R+ showed significantly lower strain parameters than group R-. These included Global Longitudinal Strain (GLS) (-11.14 ± 0.5 VS -16.78 ± 0.4, p˂0.0001), longitudinal strain rate (-1.01 ± 0.05 VS -1.07 ± 0.04, p˂0.0001), Culprit Longitudinal Strain (CulLS) (-9.74 ± 0.59 VS -15.68 ± 0.49, P˂0.0001), and culprit longitudinal strain rate (-0.95 ± 0.05 VS -1.02 ± 0.04, P˂0.0001). In the follow up study, all of the strain parameters studied were again significantly lower in the R+ than the R- group. The most sensitive and specific parameters were the GLS and CulLS (sensitivities of 91.7% and 95.8% respectively and specificities of 95% and 96.7% respectively). Conclusion: Our findings show that impaired indices of LV deformation detected two days after successful PCI for AMI may provide a predictive value in early detection of LV remodelling.","PeriodicalId":170730,"journal":{"name":"International Archives of Cardiovascular Diseases","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130941767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-07DOI: 10.23937/2643-3966/1710025
Hilda Tumwebaze, Emma Ndagiire, Judith Namuyonga, Aliku Twalib, P. Lwabi, Sulaiman Lubega
Background: Kawasaki disease (KD) is an acute systemic vasculitis which progresses to cause coronary artery abnormalities as a complication. Echocardiographic and cardiac angiographic data indicate that 20-40% of untreated KD patients develop coronary artery abnormalities. However, majority of the lesions regress over time. Timely treatment with high dose intravenous immunoglobulins (IVIG) and high dose of aspirin has been found to reduce the incidence of developing coronary artery aneurysms to 2%-3%. Data on KD in the African region is unavailable. We present a case of a 5 month old infant that presented at the Uganda Heart Institute with KD associated with coronary artery involvement and is currently undergoing follow up. Case presentation: A 5-months-old female infant presented to the pediatric emergency unit with a persistent high grade fever for 7 days with refusal to breast feed, diarrhea and irritability, a generalized maculopapular rash that had started 2 days after onset of fever. Her vaccination status was up to date. She was evaluated and initially managed for gastroenteritis and septicemia with no improvement. A pediatric cardiology review was done at day 22 of illness due to symptoms of difficulty in breathing and palpitations. Significant physical findings were of a very sick infant, febrile with generalized maculopapular rash, peeling of extremities and perineum, hyperemia of the conjunctiva bilaterally and the pharynx, no cervical lymphadenopathy. She had tachypnea, tachycardia with a gallop rhythm but no murmurs, tender hepatomegally, irritability but conscious with no signs of meningeal irritation. A transthoracic echocardiography done significantly showed dilated coronary arteries, moderate pericardial effusion with preserved ejection fraction. Laboratory findings were of leucocytosis predominantly neutrophilia, thrombocytosis, anemia, raised C-reactive protein levels, hypoalbuminemia and raised liver function tests. Blood cultures and blood smear for malaria were unremarkable. A diagnosis of KD with coronary artery involvement was made by the pediatric cardiologist. Treatment for KD was started immediately with high dose intravenous immunoglobulins (IVIG) as a single dose and high dose aspirin with remarkable improvement as the fever subsided with in 24 hours of treatment. Follow up serial transthoracic echocardiography findings showed regression of coronary artery dilatation over time and currently at 3 years of age the coronary arteries are of normal diameter for her body surface area. ISSN: 2643-3966 DOI: 10.23937/2643-3966/1710025 Hilda et al. Int Arch Cardiovasc Dis 2019, 3:025 • Page 2 of 5 • month-old infant with coronary artery involvement in Uganda in Africa.
{"title":"Coronary Artery Involvement Following Kawasaki Disease: A Case Report of a 5 Month Old African Infant","authors":"Hilda Tumwebaze, Emma Ndagiire, Judith Namuyonga, Aliku Twalib, P. Lwabi, Sulaiman Lubega","doi":"10.23937/2643-3966/1710025","DOIUrl":"https://doi.org/10.23937/2643-3966/1710025","url":null,"abstract":"Background: Kawasaki disease (KD) is an acute systemic vasculitis which progresses to cause coronary artery abnormalities as a complication. Echocardiographic and cardiac angiographic data indicate that 20-40% of untreated KD patients develop coronary artery abnormalities. However, majority of the lesions regress over time. Timely treatment with high dose intravenous immunoglobulins (IVIG) and high dose of aspirin has been found to reduce the incidence of developing coronary artery aneurysms to 2%-3%. Data on KD in the African region is unavailable. We present a case of a 5 month old infant that presented at the Uganda Heart Institute with KD associated with coronary artery involvement and is currently undergoing follow up. Case presentation: A 5-months-old female infant presented to the pediatric emergency unit with a persistent high grade fever for 7 days with refusal to breast feed, diarrhea and irritability, a generalized maculopapular rash that had started 2 days after onset of fever. Her vaccination status was up to date. She was evaluated and initially managed for gastroenteritis and septicemia with no improvement. A pediatric cardiology review was done at day 22 of illness due to symptoms of difficulty in breathing and palpitations. Significant physical findings were of a very sick infant, febrile with generalized maculopapular rash, peeling of extremities and perineum, hyperemia of the conjunctiva bilaterally and the pharynx, no cervical lymphadenopathy. She had tachypnea, tachycardia with a gallop rhythm but no murmurs, tender hepatomegally, irritability but conscious with no signs of meningeal irritation. A transthoracic echocardiography done significantly showed dilated coronary arteries, moderate pericardial effusion with preserved ejection fraction. Laboratory findings were of leucocytosis predominantly neutrophilia, thrombocytosis, anemia, raised C-reactive protein levels, hypoalbuminemia and raised liver function tests. Blood cultures and blood smear for malaria were unremarkable. A diagnosis of KD with coronary artery involvement was made by the pediatric cardiologist. Treatment for KD was started immediately with high dose intravenous immunoglobulins (IVIG) as a single dose and high dose aspirin with remarkable improvement as the fever subsided with in 24 hours of treatment. Follow up serial transthoracic echocardiography findings showed regression of coronary artery dilatation over time and currently at 3 years of age the coronary arteries are of normal diameter for her body surface area. ISSN: 2643-3966 DOI: 10.23937/2643-3966/1710025 Hilda et al. Int Arch Cardiovasc Dis 2019, 3:025 • Page 2 of 5 • month-old infant with coronary artery involvement in Uganda in Africa.","PeriodicalId":170730,"journal":{"name":"International Archives of Cardiovascular Diseases","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116613255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}