Cardiogenic shock: do not forget the possibility of Kawasaki disease

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Rheumatology

Background:

• Kawasaki disease (KD) is a critical illness in children, primarily affecting the coronary arteries.
• Cardiogenic shock is a rare but severe complication of KD, often overlooked in initial assessments.
• Misdiagnosis, particularly confusing KD with septic shock, can delay appropriate management.

Observation:

• A six-year-old boy presented with symptoms initially suggestive of septic shock.
• The patient was subsequently diagnosed with Kawasaki disease complicated by acute coronary syndrome.
• This complication led to the development of cardiogenic shock.

Findings:

• Kawasaki disease can manifest with acute coronary syndrome during its acute phase.
• Acute coronary syndrome in KD can precipitate cardiogenic shock, a life-threatening condition.
• Cardiogenic shock secondary to KD requires prompt identification and intervention.

Implications:

• Highlights the importance of considering Kawasaki disease in children presenting with shock, even if initially suspected as septic shock.
• Emphasizes the need for heightened awareness among clinicians regarding the potential for acute coronary syndrome and cardiogenic shock as KD complications.
• Suggests that early echocardiographic evaluation may be beneficial in diagnosing cardiac involvement in suspected KD cases presenting with shock.