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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Kawasaki disease – A tertiary single-centre 10 year retrospective
Session:
Posters 4 - Écran 6 - Miscelânea
Speaker:
Guilherme Lourenço
Congress:
CPC 2019
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
20. Congenital Heart Disease and Pediatric Cardiology
Subtheme:
20.7 Pediatric Cardiology
Session Type:
Posters
FP Number:
---
Authors:
Guilherme Lourenço; Pedro Oom Da Costa; Catarina Gouveia; Maria João Brito; Maria De Fátima Pinto
Abstract
<p><strong><u>Introduction:</u></strong></p> <p>Kawasaki disease (KD) is the most frequent acquired paediatric heart disease in developed world. In a recent study, epidemiology of KD in Portugal revealed to be similar to other European countries, incidence was 6.5/100.000 children under 5 years, with male predominance and male/female ratio of 1.6/1.</p> <p> </p> <p><strong><u>Methods:</u></strong></p> <p>Retrospective study of KD in hospitalized children from 2006-2016 in a Portuguese tertiary centre. Demographic, clinical, laboratory and echocardiographic parameters were evaluated.</p> <p> </p> <p><strong><u>Results:</u></strong></p> <p>41 patients were identified. Male/female ratio and mean age at diagnosis were inferior to national means: 1.3/1 and 2 years [0.25:11]; 93% <5 years, 31% <1 year. Median hospital stay was 8 days, with no fatalities. Classic KD was presented in 56% of cases; there was one case of recurrence. Intravenous immunoglobulin (IVIG) was administered between days 5-10 in 71% of cases. IVIG resistance occurred in 12%; all of these patients received a second infusion of IVIG, 60% were additionally treated with steroids, and in one case with Infliximab. Coronary artery abnormalities were found in 48% of patients in the acute phase (dilation only [z-score 2-2.5]: 17%, small-sized aneurysms [z-score 2.5-5]: 24%, medium-sized aneurysms [z-score 5-10]: 7%, no giant aneurysms were found). At 6 months follow-up, 100% of dilations had regressed, 80% of small-sized coronary artery aneurysm (CAA) had regressed, and 33% of the medium-sized CAA regressed (and the remaining 67% reduced to small-sized aneurysms). At 6 months CAA were present in 9.8% of patients. During follow-up (mean follow-up 6.9 years, range [2.3:13]) all the remaining initially small-sized aneurysms regressed, but the remaining initially medium-sized aneurysms did not regress, therefore 4.9% had CAA. Transient mitral regurgitation was found in 26% of cases, pericardial effusion occurred in 26%. Arthritis/polyarthralgia was present in 19% of cases. On follow-up no children suffered myocardial ischemic events.</p> <p> </p> <p><strong><u>Conclusions:</u></strong></p> <p>CAA incidence was initially higher than reported in the literature, but on follow-up the incidence of CAA that didn’t regress was similar. IVIG resistance was somewhat low. Long-term outcomes are positive, without a single myocardial ischemic event in the study population during follow-up.</p>
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