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Myocardial infarction caused by an aneurysm of the left main coronary artery without evidence of Kawasaki disease
  2. O LUHA,
  5. W KLEIN
  1. Department of Internal Medicine,
  2. Division of Cardiology
  3. Karl Franzens University, Graz, Austria
  1. Dr F M Fruhwald, Med.-Univ. Klinik, Auenbruggerplatz 15, A-8036 Graz, Austria email:friedrich.fruhwald{at}

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Sir,—We read the case report from Pfafferott and coworkers1 about atypical Kawasaki syndrome with great interest. The authors report the case of a 20 year old woman with acute myocardial infarction and a huge aneurysm of the left main coronary artery that was occluded by a large thrombus. Because other vascular and systemic diseases were excluded, atypical Kawasaki syndrome was diagnosed. Diagnostic criteria of Kawasaki disease include fever for five or more days unresponsive to antibiotics, bilateral congestion of the conjunctiva, peripheral limb changes including indurative oedema, and erythema followed by membranous desquamation of the fingertips, erythema of oral and pharyngeal mucosa and a strawberry tongue, a polymorphous exanthema of the trunk, and cervical lymphadenopathy. Furthermore, the diagnosis is accepted when coronary aneurysms are present in addition to four of these major symptoms.2Thrombosis of coronary aneurysms, however, often leads to myocardial …

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