Young patient presenting acute coronary syndrome

Area of Science:

• Cardiology
• Pediatric Cardiology
• Rheumatology

Background:

• Kawasaki disease (KD) typically affects young children.
• Coronary artery abnormalities are the most significant long-term complication of KD.
• Adult presentation of KD with coronary involvement is rare.

Observation:

• A young adult patient presented with recurrent acute coronary syndrome (ACS).
• The patient had a history of high-grade fever and conjunctivitis in childhood, suggestive of KD.
• Coronary angiography confirmed significant coronary artery aneurysms.

Findings:

• The patient's ACS was attributed to coronary artery aneurysms secondary to a prior KD diagnosis.
• Medical management, specifically avoiding stent implantation, was chosen for treatment.
• Successful medical treatment was achieved without the need for invasive procedures like stenting.

Implications:

• This case highlights the potential for late cardiovascular complications of Kawasaki disease in adulthood.
• It suggests that medical management can be a viable option for KD-induced coronary aneurysms causing ACS.
• Further research is needed to establish treatment guidelines for adult KD patients with coronary aneurysms and ACS.