Your browser does not support javascript. You should still be able to navigate through these materials but selftest questions will not work. Cardiology table of contents pediatric cardiology heart sounds and murmurs pediatric ekg interpretation left to right shunts quick checks obstructive cardiac lesions cyanotic cardiac lesions cardiomyopathies chest pain arrhythmias long qt syndrome (lqts) quick checks kawasaki disease (mucocutaneous lymph node syndrome) infective endocarditis rheumatic fever quick checks resources and references kawasaki disease (mucocutaneous lymph node syndrome) kawasaki disease (kd) is an acute multi-system immune-mediated vasculitis of unknown etiology which usually presents in infancy and early childhood. 85% of children are less than 5 years of age. Kd is the leading cause of acquired heart disease in children in the usa. In untreated kd patients, the incidence of coronary artery aneurysm ranges from 15-25%. Myocardial infarction from thrombotic occlusion of the coronary arteries is the principle cause of death. Kd is more common in patients of asian descent. The prognosis depends on the extent of the cardiac involvement. Pathogenesis the etiology of kd is unknown. Kd involves small to medium-sized arteries, including the coronary arteries; the extent of the coronary artery involvement is the critical that determines morbidity and mortality. Investigators propose that mediators such as tumor necrosis factor (tnf), interleukin (il)-1b, interferon (inf) and il-6 produced by activated t-cells and macrophages promote vascular injury. The earliest pathological change reported in the vessel wall is subendothelial accumulation of t-cells, mononuclear cells, macrophages and monocytes. Clinical presentation kd is divided into three phases. The acute phase begins with onset of high fever without an apparent source and can last for 1-2 weeks. Acute myocardial infarction may occur during the acute phase due to perivasculitis and vasculitis. In the subacute phase, which may last for 2-4 weeks, the fever subsides. Desquamation of the skin and coronary artery aneurysms appear in this phase. The platelet count might rise above 106 per mm3 in this phase. During the convalescent phase, the symptoms resolve and the sedimentation returns to normal, usually within 6-8 weeks following onset of the illness. Making the diagnosis fever of unknown origin lasting for 3 days or more, in addition to fourof the following signs: bilateral conjunctival injection without exudates. Changes in mucous membranes such as injected or fissured lips, strawberry tongue. Extremity change including erythema of palms or soles and edema of the hands or the feet. Polymorphous exanthema. Acute cervical lymphadenopathy (and isolated node > 1. cheap generic viagra generic viagra online cheap viagra viagra for sale generic viagra online buy cheap viagra generic viagra buy viagra online 5 cm in diameter).
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