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Lifetime cardiovascular management of patients with previous Kawasaki disease
Paul Brogan1, Jane C Burns2,3, Jacqueline Cornish4
1Infection, Inflammation, and Rheumatology, UCL Institute of Child Health, London, UK.
Insights
Kawasaki disease (KD), an inflammatory condition in children, can cause coronary artery aneurysms. This guidance addresses long-term management for adults with KD vascular complications and emergency care for acute coronary issues.
Area of Science:
- Cardiology
- Pediatrics
- Rheumatology
Background:
- Kawasaki disease (KD) is a pediatric inflammatory disorder affecting coronary arteries.
- Aneurysm formation occurs in up to one-third of untreated KD patients, posing lifelong risks.
- KD is the leading cause of acquired heart disease in children in developed nations.
Purpose of the Study:
- Provide guidance on long-term management for KD vascular complications.
- Offer guidance on emergency management of acute coronary complications in KD patients.
- Address the growing need for adult services to manage KD survivors.
Main Methods:
- This document provides clinical guidance.
- It focuses on managing long-term vascular complications and acute coronary events.
- Guidance for acute KD management is referenced as published elsewhere.
Main Results:
- Untreated KD can lead to coronary aneurysms and lifelong risks like thrombosis and stenosis.
- Increasing KD incidence worldwide necessitates greater awareness.
- Lack of awareness in UK clinicians and adult services can delay diagnosis and treatment.
Conclusions:
- Effective long-term management of KD vascular complications is crucial.
- Prompt emergency care for acute coronary events in KD patients is vital.
- Enhanced awareness and expertise in adult services are needed for KD survivors.
Abstract:
Kawasaki disease (KD) is an inflammatory disorder of young children, associated with vasculitis of the coronary arteries with subsequent aneurysm formation in up to one-third of untreated patients. Those who develop aneurysms are at life-long risk of coronary thrombosis or the development of stenotic lesions, which may lead to myocardial ischaemia, infarction or death. The incidence of KD is increasing worldwide, and in more economically developed countries, KD is now the most common cause of acquired heart disease in children. However, many clinicians in the UK are unaware of the disorder and its long-term cardiac complications, potentially leading to late diagnosis, delayed treatment and poorer outcomes. Increasing numbers of patients who suffered KD in childhood are transitioning to the care of adult services where there is significantly less awareness and experience of the condition than in paediatric services. The aim of this document is to provide guidance on the long-term management of patients who have vascular complications of KD and guidance on the emergency management of acute coronary complications. Guidance on the management of acute KD is published elsewhere.
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