Pregnancy and breast cancer in a patient with complicated Kawasaki Disease, as if one problem was not enough: a case report.
Breast cancer
Case report
Coronary aneurysms
HELLP
Kawasaki syndrome
Pregnancy
Journal
European heart journal. Case reports
ISSN: 2514-2119
Titre abrégé: Eur Heart J Case Rep
Pays: England
ID NLM: 101730741
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
06
05
2022
revised:
14
06
2022
accepted:
01
11
2022
entrez:
1
12
2022
pubmed:
2
12
2022
medline:
2
12
2022
Statut:
epublish
Résumé
Due to the increasing prevalence of Kawasaki Disease (KD) in adulthood, the number of women considering pregnancy is growing. There are limited data on the course of pregnancy in KD with coronary artery involvement. We report on the pregnancy outcome of a 30-year-old woman with KD who was successfully resuscitated for ventricular tachycardia 3 years before. At that time, bypass surgery and later implantable cardioverter-defibrillator implantation were performed because of thrombotically occluded calcified giant coronary aneurysms. The pregnancy course was initially uncomplicated, however, at 31 weeks of gestation, left-sided breast cancer was diagnosed. Weighing maximum therapeutic efficacy against acceptable foetal and maternal cardiotoxic risk, our multidisciplinary team decided on neoadjuvant chemotherapy. The mother and foetus tolerated the therapy well. However, at 36 weeks of gestation, due to HELLP (haemolysis, elevated liver, low platelets) syndrome, a caesarean section had to be performed. The newborn was healthy with good APGAR (appearance, pulse, grimace, activity, respiration) scores. Three weeks after delivery, chemotherapy was restarted and at Week 4 after the caesarean section, the tumour was no more detectable. We discuss data on pregnancy and KD and outline that pregnancy can be considered if the clinical condition is good and left ventricular function is preserved. We also address possible therapeutic approaches and care for breast cancer in pregnancy and coexisting cardiovascular disease. The extraordinary importance of interdisciplinary cooperation between different disciplines in such complex clinical disease conditions is emphasized.
Sections du résumé
Background
UNASSIGNED
Due to the increasing prevalence of Kawasaki Disease (KD) in adulthood, the number of women considering pregnancy is growing. There are limited data on the course of pregnancy in KD with coronary artery involvement.
Case summary
UNASSIGNED
We report on the pregnancy outcome of a 30-year-old woman with KD who was successfully resuscitated for ventricular tachycardia 3 years before. At that time, bypass surgery and later implantable cardioverter-defibrillator implantation were performed because of thrombotically occluded calcified giant coronary aneurysms. The pregnancy course was initially uncomplicated, however, at 31 weeks of gestation, left-sided breast cancer was diagnosed. Weighing maximum therapeutic efficacy against acceptable foetal and maternal cardiotoxic risk, our multidisciplinary team decided on neoadjuvant chemotherapy. The mother and foetus tolerated the therapy well. However, at 36 weeks of gestation, due to HELLP (haemolysis, elevated liver, low platelets) syndrome, a caesarean section had to be performed. The newborn was healthy with good APGAR (appearance, pulse, grimace, activity, respiration) scores. Three weeks after delivery, chemotherapy was restarted and at Week 4 after the caesarean section, the tumour was no more detectable.
Discussion
UNASSIGNED
We discuss data on pregnancy and KD and outline that pregnancy can be considered if the clinical condition is good and left ventricular function is preserved. We also address possible therapeutic approaches and care for breast cancer in pregnancy and coexisting cardiovascular disease. The extraordinary importance of interdisciplinary cooperation between different disciplines in such complex clinical disease conditions is emphasized.
Identifiants
pubmed: 36451807
doi: 10.1093/ehjcr/ytac435
pii: ytac435
pmc: PMC9704422
doi:
Types de publication
Case Reports
Langues
eng
Pagination
ytac435Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.
Déclaration de conflit d'intérêts
Conflict of interest: None declared
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