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Kawasaki disease: late cardiovascular sequelae
Lori B Daniels1, John B Gordon, Jane C Burns
1Division of Cardiology, Department of Medicine, University of California, La Jolla, San Diego, California, USA. lbdaniels@ucsd.edu
Current Opinion in Cardiology
|October 19, 2012
Summary
Adult cardiologists are increasingly seeing patients with Kawasaki disease (KD) who have long-term cardiac complications. Early detection and specialized follow-up are crucial for managing coronary artery aneurysms and preventing myocardial infarction in KD survivors.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Immunology
Background:
- Kawasaki disease (KD) is a pediatric illness with increasing recognition in adult patients.
- Adult cardiologists are now encountering long-term cardiovascular sequelae of KD.
- Understanding late cardiac complications in KD survivors is essential.
Purpose of the Study:
- To review recent advancements in understanding late cardiac sequelae of Kawasaki disease.
- To inform adult cardiologists about managing KD patients with cardiovascular complications.
Main Methods:
- Literature review of recent studies on Kawasaki disease.
- Analysis of long-term cardiac outcomes in KD patients.
- Comparison of KD vasculopathy with atherosclerosis.
Main Results:
- Persistent coronary aneurysms in KD patients are linked to high rates of thrombosis and myocardial infarction.
- The role of persistent inflammation and myofibroblast activity in arterial remodeling is highlighted.
- KD vasculopathy appears distinct from atherosclerosis, necessitating different management strategies.
Conclusions:
- Patients with coronary aneurysms (persistent, remodeled, or regressed) post-KD face elevated cardiovascular risk.
- Long-term cardiology follow-up is critical for KD survivors.
- Management strategies for KD vasculopathy differ from those for atherosclerosis.
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