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Valvular heart disease in Kawasaki syndrome--incidence and natural history

T Akagi, H Kato, H K Inoue

    The Kurume Medical Journal
    |January 1, 1989
    PubMed

    Insights

    Kawasaki syndrome can lead to valvular heart disease, particularly mitral regurgitation, in about 1% of cases. This complication is linked to prolonged fever and more severe disease, suggesting a need for careful cardiac monitoring.

    Area of Science:

    • Pediatric Cardiology
    • Rheumatology
    • Cardiovascular Research

    Background:

    • Kawasaki syndrome is a leading cause of acquired heart disease in children.
    • Valvular heart disease, including mitral and aortic regurgitation, has been anecdotally associated with Kawasaki syndrome.

    Purpose of the Study:

    • To determine the incidence and natural history of valvular heart disease in patients with Kawasaki syndrome.
    • To compare clinical characteristics of Kawasaki syndrome patients with and without valvular heart disease.

    Main Methods:

    • Analysis of 1215 Kawasaki syndrome cases from 1973-1988.
    • Identification of 13 cases with new-onset valvular heart disease (12 mitral regurgitation, 1 aortic regurgitation).
    • Comparison of demographic and clinical data, including fever duration and coronary artery lesion incidence, between groups.

    Main Results:

    • The incidence of valvular heart disease was 1.0% for mitral regurgitation and 0.1% for aortic regurgitation.
    • Patients with valvular heart disease had significantly longer fever duration (20.3 days vs 10.3 days) and higher incidence of coronary artery lesions (p<0.001).
    • Valvular heart disease typically appeared within 1 month, with resolution in some cases and persistent murmurs or heart failure in others.

    Conclusions:

    • Valvular heart disease in Kawasaki syndrome appears to be associated with more severe disease presentations.
    • The findings suggest distinct etiologies for early-onset versus late-onset valvular complications.
    • Long-term cardiac monitoring is crucial for Kawasaki syndrome patients, especially those with prolonged fever or coronary involvement.

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