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Scientific letters
Pregnancy and delivery in patients with coronary artery lesions caused by Kawasaki disease
  1. E Tsuda1,
  2. Y Ishihara2,
  3. K Kawamata2,
  4. S Tsukano1,
  5. R Negi2,
  6. S Echigo1,
  7. Y Chiba2
  1. 1Department of Paediatrics, National Cardiovascular Center, Osaka, Japan
  2. 2Department of Obstetrics, National Cardiovascular Center, Osaka, Japan
  1. Correspondence to:
    Dr Etsuko Tsuda
    Department of Paediatrics, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita-shi, Osaka, 565-8565, Japan; etsudahsp.ncvc.go.jp

http://dx.doi.org/10.1136/hrt.2004.058842

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    Thirty seven years have passed since the first description of Kawasaki disease (KD) and some women with coronary artery lesions caused by KD are now of childbearing age1,2 The incidence of giant aneurysms leading to ischaemic heart disease among women is about one third that among men. There is little information on managing pregnancy and delivery in patients with coronary artery disease.3,4 We analysed the clinical course of pregnancy and delivery in this population and determined the nature of problems.

    PATIENTS AND METHODS

    We encountered 13 pregnancies and deliveries in 10 patients who had coronary artery lesions caused by KD from 1993 to 2004 in our follow up clinic. Their ages at delivery ranged from 18–34 years (median 28 years) (table 1). All patients underwent cardiac catheterisation including selective coronary angiography and left ventriculography before pregnancy. The interval between the latest coronary angiogram and delivery ranged from eight weeks to eight years. All patients underwent a treadmill test and exercise stress radioimmunological myocardial imaging before pregnancy.

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    Table 1

     Coronary artery lesions on coronary angiograms and medication, mode of delivery, and anaesthesia

    RESULTS

    Nine patients had a normal left ventricular …

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