{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:10Z","timestamp":1753876270927,"version":"3.41.2"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:00:00Z","timestamp":1623024000000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Ruptured coronary artery aneurysm is rare, but the most serious complications of an acute phase of Kawasaki disease (KD) with giant coronary artery aneurysm (GCAA). Progressive or super GCAA, which rapidly dilates and continue to increase over a diameter of 10\u2009mm, are more susceptible to rupture.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We report the case of a 6-year-old boy with KD who had multiple super GCAAs with a high risk of GCAA rupture. On admission to our hospital, he presented with fever, chest pain, and Stage II hypertension. Echocardiographic Z-scores adjusted for body surface area were used for measurements. The coronary artery diameter of segment 1 was 24.3\u2009mm with a Z-score of 20.8; the diameter of segment 3 was 24.4\u2009mm; the diameter of the left anterior descending branch was 32.6\u2009mm with a Z-score of 20.1. The super GCAAs showed a tendency to expand compared to the latest echocardiography, and thrombus formation was observed in the super GCAA of segment 3. The patient was treated with anti-inflammatory therapy, antithrombotic therapy, and antihypertensive therapy with continuous arterial pressure monitoring with the goal of not exceeding the 5th percentile of the normal standard during the period when there was a risk of progressive coronary aneurysm expansion. He was discharged without any neurological complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>We speculated that the patient's hypertension was the cause of an expanding coronary artery aneurysm. In conclusion, KD patients with super GCAA may benefit from aggressive blood pressure control with continuous arterial pressure monitoring.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab161","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T09:20:44Z","timestamp":1623057644000},"source":"Crossref","is-referenced-by-count":0,"title":["Importance of blood pressure control in Kawasaki disease with expanded multiple giant coronary aneurysms with a 32\u2009mm maximum diameter: a case report"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7032-4807","authenticated-orcid":false,"given":"Yuji","family":"Moritoh","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology, Hiroshima Citizens Hospital , 7-33 Moto-machi , Hiroshima 730-8518, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4008-8567","authenticated-orcid":false,"given":"Masahiro","family":"Kamada","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Hiroshima Citizens Hospital , 7-33 Moto-machi , Hiroshima 730-8518, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinsaku","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hiroshima Citizens Hospital , 7-33 Moto-machi , Hiroshima 730-8518, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8143-414X","authenticated-orcid":false,"given":"Koji","family":"Kido","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hiroshima Citizens Hospital , 7-33 Moto-machi , Hiroshima 730-8518, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,6,7]]},"reference":[{"key":"2022081607004229800_ytab161-B1","doi-asserted-by":"crossref","first-page":"e927","DOI":"10.1161\/CIR.0000000000000484","article-title":"Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association","volume":"135","author":"McCrindle","year":"2017","journal-title":"Circulation"},{"key":"2022081607004229800_ytab161-B2","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1111\/ped.13809","article-title":"Nationwide epidemiologic survey of Kawasaki disease in Japan, 2015-2016","volume":"61","author":"Makino","year":"2019","journal-title":"Pediatr Int"},{"key":"2022081607004229800_ytab161-B3","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.echo.2016.03.017","article-title":"A new Z score curve of the coronary arterial internal diameter using the lambda-mu-sigma method in a pediatric population","volume":"29","author":"Kobayashi","year":"2016","journal-title":"J Am Soc Echocardiogr"},{"key":"2022081607004229800_ytab161-B4","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1016\/j.jtcvs.2014.02.035","article-title":"Rupture of a coronary artery aneurysm in Kawasaki disease: a rare case and review of the literature for the past 15 years","volume":"147","author":"Miyamoto","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022081607004229800_ytab161-B5","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1007\/s00431-005-0016-9","article-title":"A fatal case of ruptured giant coronary artery aneurysm","volume":"165","author":"Imai","year":"2006","journal-title":"Eur J Pediatr"},{"key":"2022081607004229800_ytab161-B6","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1161\/01.CIR.51.4.5","article-title":"A reporting system on patients evaluated for coronary artery disease. 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