Author/Editor		Vesel, Samo
Title		Spremembe na srcu pri Kawasakijevi bolezni
Translated title		Heart involvement in Kawasaki disease
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 41, št. Suppl 2
Publication year		2002
Volume		str. 139-43
Language		slo
Abstract		Kawasaki disease is the most important acquired heart disease in children. The pathogenetic basis of this disease is acute, non-specific systemic vasculitis. Approximately 25% of children with untreated Kawasaki disease develop coronary lesions. Combined treatment with gammaglobulins and aspirin significantly reduces the prevalence of coronary artery abnormalities. The most serious complications of Kawasaki disease are acute myocardial infarction and development of ischemic cardiomyopathy. The symptoms of acute myocardial infarction in young children are non-specific. In the event of infarction of very recent onset, thrombolytic therapy should be considered. Treatment of coronary artery stenosis is possible by percutaneous transluminal angioplasty or coronary artery bypass grafting. Patients can also be stratified according to relative risk for ischemia, based on echocardiographic or angiographic assessment of coronary arteries. This may serve as a guide in patient management issues such as antiplatelet or anticoagulant therapy, restriction of physical activity and frequency and type of cardiac evaluation.
Summary		Kawasakijeva bolezen je najpomembnejša pridobljena bolezen srca pri otrocih. Patogenetska osnova bolezni je akutni, nespecifični sistemski vaskulitis. Anevrizme na koronarnih arterijah se pojavijo pri četrtini nezdravljenih bolnikov. Zdravljenje z intravenskimi gamaglobulini in aspirinom nevarnost nastanka anevrizem znatno zmanjša. Najnevarnejša zapleta bolezni sta akutni infarkt srčne mišice in ishemična kardiomiopatija. Klinična slika akutnega miokardnega infarkta pri majhnem otroku je nespecifična. Pri akutnem miokardnem infarktu se odločamo za zdravljenje z zdravili (tromboliza). Zdravljenje zožitev na koronarnih arterijah je intervencijsko ali kardiokirurško. Na osnovi sprememb na koronarnih arterijah lahko delimo bolnike, glede na tveganje za razvoj akutnega miokardnega infarkta ali ishemične kardiomiopatije, v pet skupin. Uvrstitev bolnika v določeno skupino tveganja je ključna pri določitvi potrebe po stalnem antiagregacijskem oz. antikoagulacijskem zdravljenju, pri omejitvi fizičnih aktivnosti in pri načrtovanju pogostosti in obsega kardiološkega sledenja.
Descriptors		MUCOCUTANEOUS LYMPH NODE SYNDROME HEART DISEASES CHILD MYOCARDIAL INFARCTION CORONARY DISEASE