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Valvular heart disease in Kawasaki syndrome: incidence and natural history

T Akagi1, H Kato, O Inoue

  • 1Department of Pediatrics and Child Health, Kurume University, School of Medicine, Japan.

American Heart Journal
|August 1, 1990
PubMed

Insights

Kawasaki syndrome can cause valvular heart disease, affecting 1.1% of patients. Some cases resolve spontaneously, while others persist due to valve or papillary muscle issues.

Area of Science:

  • Pediatric Cardiology
  • Rheumatology
  • Cardiovascular Medicine

Background:

  • Kawasaki disease is a leading cause of acquired heart disease in children.
  • Valvular heart disease is a potential complication, but its incidence and natural history are not fully understood.

Purpose of the Study:

  • To determine the incidence of valvular heart disease in children with Kawasaki disease.
  • To investigate the natural history and potential mechanisms of valvular heart disease in this population.

Main Methods:

  • Retrospective analysis of 1215 patients with Kawasaki disease.
  • Identification of patients with new heart murmurs post-disease onset.
  • Comparison of patients with and without valvular lesions.

Main Results:

  • 13 patients (1.1%) developed valvular heart disease (12 mitral regurgitation, 1 aortic regurgitation).
  • Patients with valvular disease had longer fever duration and higher incidence of coronary artery lesions.
  • Heart murmurs resolved within 2 months in 5 patients; persisted for ≥2 years in 6 patients (all with valve prolapse).

Conclusions:

  • Valvular heart disease is an uncommon but significant complication of Kawasaki disease.
  • Two distinct mechanisms may underlie valvular heart disease in Kawasaki disease: pancarditis leading to spontaneous resolution and ischemia-induced valve/papillary muscle dysfunction causing persistence.

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