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Coronary aneurysms in infants and young children with acute febrile mucocutaneous lymph node syndrome
Insights
Kawasaki disease, a condition in children, can lead to heart complications like coronary aneurysms. While many recover, some experience serious cardiac issues, highlighting the need for ongoing cardiac monitoring.
Area of Science:
- Pediatrics
- Cardiology
- Immunology
Background:
- Kawasaki disease, first described in 1967, is an acute febrile illness in infants and children.
- It typically presents with mucocutaneous involvement and cervical lymphadenopathy.
- While prognosis is generally good, a small percentage experience sudden cardiac death due to acute heart failure.
Purpose of the Study:
- To investigate the cardiac sequelae of Kawasaki disease in surviving patients.
- To assess the prevalence and progression of coronary artery abnormalities following the acute illness.
Main Methods:
- Coronary angiography was performed on 20 patients who had recovered from Kawasaki disease.
- Follow-up angiography was conducted in select cases to monitor changes in coronary aneurysms.
Main Results:
- Twelve out of 20 patients (60%) exhibited abnormal coronary angiograms.
- Seven patients had coronary aneurysms; complete regression was observed in two patients upon follow-up.
- One patient developed mitral regurgitation due to papillary muscle dysfunction; another had an asymptomatic coronary aneurysm two years post-illness.
Conclusions:
- Coronary artery abnormalities are a significant complication of Kawasaki disease, even in survivors.
- Coronary aneurysms can regress, but long-term cardiac monitoring is crucial for affected individuals.
- Kawasaki disease can lead to diverse cardiac complications, including valvular dysfunction.
Abstract:
In 1967, Kawasaki, in Japan, first described a new syndrome affecting infants and young children-an acute, febrile illness with mucocutaneous involvement associated with swelling of cervical lymph nodes. The prognosis is usually good but recently it has become evident that 1-2 percent of the patients die suddenly from acute heart failure. Infantile polyarteritis (nodosa-like arteritis) accompained by coronary aneurysm and thrombosis has been noted in postmortem examinations. Twenty patients surviving the illness were examined by coronary angiography; 12 of the 20 had abnormal coronary angiograms; seven patients had coronary aneurysms. Complete regression of the coronary aneurysms was proved in two patients at subsequent angiography. One patient developed mitral regurgitation as a result of papillary muscle dysfunction. One had a coronary aneurysm without symptoms two years after the onset of illness.