Acute myocardial ischemia in adults secondary to missed Kawasaki disease in childhood.

Coronary artery aneurysms that occur in 25% of untreated Kawasaki disease (KD) patients may remain clinically silent for decades and then thrombose resulting in myocardial infarction. Although KD is now the most common cause of acquired heart disease in children in Asia, the United States, and Western Europe, the incidence of KD in Egypt is unknown. We tested the hypothesis that young adults in Egypt presenting with acute myocardial ischemia may have coronary artery lesions because of KD in childhood.

Effect of pretreatment antistreptokinase antibody and streptococcal infection on the efficacy and dosage of streptokinase in acute myocardial infarction.

Objectives: The objective of the study is to determine if the presence of antistreptokinase (ASK) antibody in the blood, leads to ineffective thrombolytic therapy with streptokinase (SK) in acute myocardial infarction (AMI) and to investigate if increased dose of streptokinase (2.5 million units) could improve the infarct-related artery (IRA) patency or the clinical outcome in these patients.

Methods: The study was conducted between 1994 and 2001 in 2 institutions; King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia and in Kasr El-Aini Faculty of Medicine, Cairo, Egypt.

FAMILIAL VALVULAR PULMONIC STENOSIS INVOLVING THREE SIBLINGS.

This report describes the cases of three mentally and physically well-developed siblings, 12, 10, and 8 years of age, with varying degrees of isolated valvular pulmonic stenosis not related to age. The severest lesion occurred in the middle patient and was associated with a right-to-left shunt through a patent foramen ovale. The three children had no other siblings, and there was no history of congenital heart disease among close relatives.

ECHOCARDIOGRAPHIC FINDINGS IN BACTERIAL ENDOCARDITIS.

Fifteen echocardiographic recordings in nine patients with bacterial endocarditis revealed vegetations in six cases. The vegetations appeared as uneven, irregular thickening of a valve, a mass of shaggy, dense echoes attached to a leaflet or cusp, or a mass of irregular dense echoes in the cavity or outflow tract of the left ventricle. Such findings were seen only on the echocardiograms of very sick patients with severe valvular lesions.