Oblivion: autopsy findings of a 31-year-old man with sudden cardiac arrest, a case report of a sequalae of Kawasaki disease

Gallego, Daniel Fernando; Ruiz, Maria Eugenia Zuluaga; Marshall, Desiree Ann

doi:10.4322/acr.2021.404

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Sumário

Autopsy Case Report • Autops. Case Rep. 12 • 2022 • https://doi.org/10.4322/acr.2021.404 copy

Oblivion: autopsy findings of a 31-year-old man with sudden cardiac arrest, a case report of a sequalae of Kawasaki disease

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

A 31-year-old man presented to the hospital after suffering a sudden cardiac arrest. Despite optimal therapy, the patient passed away. His medical history included febrile rash at age 2. At autopsy, there was aneurysmal dilation and severe coronary artery stenosis by atherosclerotic plaques and myocardial fibrosis. These findings were presumed to be due to complications of Kawasaki disease, given the remote history of severe febrile rash as a toddler and the presence of chronic coronary artery injury, recanalization, and thrombosis with ischemic heart disease leading to sudden cardiac collapse and death.

Keywords
Coronary Aneurysm; Death, Sudden; Mucocutaneous Lymph Node Syndrome; Forensic Pathology; Coronary Disease

Coronary arteries	Aneurysmal dilation	Atherosclerosis
Left main	Not significant	Not significant
Left anterior descending	1) 3 cm in length, starting 2.5 cm from ostium. Up to cm in 1.8 cm in diameter.	Not significant
Left anterior descending	2) 0.8 cm in length, distal portion. Up to 0.8 cm in diameter.	Not significant
Left circumflex	Not significant	1) Complete occlusion, 1.5 cm from ostium
Left circumflex	Not significant	2) Variable narrowing 70-90% throughout vessel length
Right	1) 4 cm in length, starting adjacent to ostium. Up to 1.4 cm in diameter.	1) Complete occlusion, 2.5 cm from ostium
		2) 90% occlusion, 4.0 cm from ostium
		3) 90% occlusion, distally, at the origin of the posterior coronary artery

Hospital Universitário da Universidade de São Paulo Hospital Universitário da Universidade de São Paulo, Av. Prof. Lineu Prestes, 2565 - Cidade Universitária, 05508-000 - São Paulo - SP - Brasil, (16) 3307-2068, (16) 3307-2068 - São Paulo - SP - Brazil
E-mail: autopsy.hu@gmail.com

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[1] Authors’ contributions: All the authors (Daniel Fernando Gallego, Maria Eugenia Zuluaga Ruiz and Desiree Ann Marshall) participated in the design, writing, editing, and approval of the final manuscript.