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Silent Kawasaki Disease Affecting Multiple Coronary Arteries in a 39-Year-Old Egyptian Woman

Hamdy Singab1, Gamal Sami1, Mahmoud Tag El Sabah2

  • 1Department of Cardiac Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Texas Heart Institute Journal
|April 14, 2022
PubMed

Insights

This case study highlights chronic Kawasaki disease in an adult, presenting as coronary artery thrombosis and aneurysms. Early recognition is crucial for managing this rare condition in adults.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Rheumatology

Background:

  • Kawasaki disease is an acute febrile illness causing coronary artery vasculitis, a leading cause of acquired heart disease in young individuals.
  • It is the primary cause of myocardial infarction and sudden cardiac death in children and young adults in developed nations.

Observation:

  • A 39-year-old Egyptian woman presented with unstable angina, despite having no typical risk factors for ischemic heart disease.
  • Coronary angiography revealed critical stenosis and multiple aneurysms, indicative of severe coronary artery disease.
  • Intraoperative findings showed the left internal mammary artery was unsuitable for grafting due to occlusive lesions and aneurysms.

Findings:

  • Histopathology confirmed chronic Kawasaki disease-associated systemic vasculitis.
  • This represents a rare occurrence of Kawasaki disease in the Arabian Mediterranean region.
  • The patient's presentation underscores the potential for chronic, silent Kawasaki disease in adulthood.

Implications:

  • This case emphasizes the importance of considering Kawasaki disease in adult patients with unexplained coronary artery abnormalities and thrombosis.
  • Increased clinician awareness of Kawasaki disease in adults may improve diagnosis and management, potentially preventing severe cardiac complications.
  • Further research into the long-term sequelae and adult presentation of Kawasaki disease is warranted.

Keywords:
Adultage factorscoronary artery disease/epidemiology/etiologydilatation, pathologicdisease progressionmucocutaneous lymph node syndrome/complications/diagnosis/etiology/ethnology/surgerytreatment outcomevasculitis

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