Adult Kawasaki disease

摘要

A 44-year-old male presented with 1 h history of substernal, persistent pressure-1 ike chest pain. The pain had no radiation and started while he was watching TV. He denied associated nausea, vomiting, palpitations or shortness of breath. He has history of hypertension controlled with irbesartan. He never smoked or drank alcohol. Exam showed normal vital signs; cardiovascular examination showed regular rate and rhythm, no gallops, murmurs or pericardial rub, had symmetric and bounding distal pulses. Electrocardiogram showed normal sinus rhythm with no ST or T wave changes, and with normal intervals. Chest X-ray was normal. Laboratory studies showed elevated cardiac enzymes: CK 662 U/L (reference range: 30-220 U/L) and CK MB 8.1% (reference range: 0.0-4.0%), troponin T 2.28ng/ml (reference range: 0.00-0.1 Ong/ml). He underwent an emergent left heart catheterization (LHC) for non-ST-elevation myocardial infarction (NSTEMI).