Giant coronary aneurysms in a young adult patient with Kawasaki disease
Alexis Canino-Rodríguez1, Rafael A Cox
1Section of Cardiology, Department of Medicine, University of Puerto Rico School of Medicine, San Juan. alexiscanino@hotmail.com
Insights
Kawasaki disease, a childhood vasculitis, can cause coronary aneurysms. This case highlights silent giant coronary aneurysms in an adult, emphasizing the need for awareness and long-term monitoring.
Area of Science:
- Cardiology
- Pediatric Rheumatology
- Vascular Biology
Background:
- Kawasaki disease is a primary cause of pediatric acquired heart disease globally.
- Coronary artery aneurysms are the main cause of morbidity and mortality.
- Long-term sequelae in adults remain largely unknown.
Observation:
- A young, asymptomatic Puerto Rican male presented with multiple giant coronary aneurysms.
- The patient had a history of Kawasaki disease, previously undiagnosed.
- Diagnosis was made in an adult cardiology clinic.
Findings:
- The case illustrates the potential for clinically silent coronary artery aneurysms in adults.
- Giant coronary aneurysms can develop years after childhood Kawasaki disease.
- This presentation underscores the importance of recognizing delayed complications.
Implications:
- Highlights the importance of long-term cardiovascular surveillance in adults with a history of Kawasaki disease.
- Suggests that Kawasaki disease may have a more significant long-term impact on adult cardiovascular health than previously recognized.
- Emphasizes the need for increased awareness among adult cardiologists regarding potential sequelae of childhood vasculitis.
Abstract:
Kawasaki disease is an acute, self-limited vasculitis of childhood and the principal cause of acquired heart disease in children in several parts of the world. Its major morbidity and mortality is related to the development of coronary aneurysms. The long-term impact of this disease in adults is not known, however, clinically silent coronary artery aneurysms may be recognized after a sudden cardiac event, even death. We report a case of Kawasaki disease in a young asymptomatic Puerto Rican man who presented to our Adult Cardiology Clinic with multiple giant coronary aneurysms. A brief review of the epidemiology, etiology, pathophysiology, clinical features, therapeutic modalities, prognosis and complications of this condition is also included.
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