[Possible Kawasaki disease in a 56 years-old male patient diagnosed in sequelae phase]

Area of Science:

• Cardiology
• Pediatric Rheumatology
• Vascular Medicine

Background:

• Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
• While typically presenting in childhood, chronic sequelae can manifest in adulthood.
• Adult presentation of chronic KD is rare, posing diagnostic challenges.

Observation:

• A 56-year-old male presented with symptoms suggestive of an acute ischemic episode.
• Coronary angiography revealed significant dilation of the left main coronary artery and the proximal left anterior descending artery.
• The right coronary artery exhibited marked dilation, measuring 10mm in diameter in its proximal and medial segments.

Findings:

• The observed coronary artery abnormalities, including aneurysmal dilation, are highly suggestive of chronic Kawasaki disease.
• The extent of dilation in multiple coronary segments points towards a long-standing inflammatory process.
• The patient's presentation in adulthood with these findings underscores the potential for late-onset complications of KD.

Implications:

• This case highlights the importance of considering chronic Kawasaki disease in adult patients presenting with ischemic events and coronary abnormalities.
• Recognition of these chronic sequelae is crucial for appropriate cardiovascular risk stratification and management in affected adults.
• Further research into the long-term cardiovascular outcomes and optimal monitoring strategies for adults with a history of Kawasaki disease is warranted.