[Giant coronary aneurysms in infants with Kawasaki disease]
Antonio Sánchez Andrés1, Inmaculada Salvador Mercader1, Julia Seller Moya1
1Servicio de Cardiología Pediátrica, Hospital Universitario y Politécnico La Fe, Valencia, España.
Insights
Kawasaki disease (KD) can lead to coronary artery lesions, especially aneurysms, in children. Early diagnosis and monitoring are crucial for managing cardiovascular risk and preventing long-term complications.
Area of Science:
- Pediatric Cardiology
- Vascular Inflammation
Background:
- Kawasaki disease (KD) is an acute vasculitis of unknown origin, primarily affecting males.
- Long-term effects are linked to coronary lesions, particularly aneurysms, with poor prognosis for giant aneurysms due to thrombosis risk.
Purpose of the Study:
- To describe the epidemiology and diagnostic methods of KD in 8 pediatric cases.
- To review acute and long-term cardiovascular sequelae treatments for KD.
Main Methods:
- Descriptive analysis of patients with KD and coronary lesions.
- Admitted to the Paediatric Cardiology Unit of La Fe University Hospital (Valencia).
Main Results:
- All patients had multi-arterial involvement; early diagnosis in only two cases.
- No severe ventricular dysfunction during the acute phase.
- Treatment involved IVIG and aspirin; dual antiplatelet therapy and corticosteroids for coronary thrombosis; persistent silent aneurysms.
Conclusions:
- KD is the leading cause of acquired heart disease in children.
- Delayed diagnosis increases coronary lesion likelihood and future cardiovascular event risk.
- Close monitoring of this subgroup is essential for cardiovascular risk management.
Introduction:
Kawasaki disease (KD) is an acute vasculitis of unknown origin and predominant in males. The long-term effects of the disease depend on whether there are coronary lesions, particularly aneurysms. The prognosis of patients with giant aneurysms is very poor due to their natural progression to coronary thrombosis or severe obstructive lesions.
Objectives:
A series of 8 cases is presented where the epidemiology and diagnostic methods are described. The treatment of the acute and long-term cardiovascular sequelae is also reviewed.
Methods:
A descriptive analysis was conducted on patients admitted to the Paediatric Cardiology Unit of La Fe University Hospital (Valencia) with KD and a coronary lesion.
Results:
More than one artery was involved in all patients. Although early diagnosis was established in only two cases, none of the patients had severe impairment of ventricular function during the acute phase. Treatment included intravenous gammaglobulin and acetylsalicylic acid at anti-inflammatory doses during the acute phase. A combination of dual antiplatelet therapy and corticosteroids was given in cases of coronary thrombosis. The silent aneurysms continue to persist.
Conclusions:
KD is the most common cause of acquired heart disease in children. The delay in diagnosis is associated with a greater likelihood of coronary lesions that could increase the risk of cardiovascular events in adulthood. Thus, this subgroup requires close clinical monitoring for a better control of cardiovascular risk factors over time.
Related Concept Videos
01:30Aneurysm I: Introduction
01:26Aneurysm III: Interprofessional Care
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:21Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
01:26Coronary Artery Disease II: Pathophysiology
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests