A 14.5-Year-Old Boy with Coronary Obstruction after Kawasaki Disease: A Case Report

Area of Science:

• Pediatric Cardiology
• Rheumatology
• Vascular Biology

Background:

• Kawasaki disease (KD) is a primary cause of acquired pediatric heart disease, characterized by systemic vasculitis.
• Coronary artery aneurysms are a significant complication of KD, potentially leading to stenosis or obstruction.
• Early diagnosis and management of KD are critical to prevent long-term cardiovascular sequelae.

Observation:

• This report details a 14.5-year-old male with a history of KD at 6 months, presenting with multiple coronary artery aneurysms.
• Follow-up imaging at 14 years revealed regression of left coronary artery aneurysms but persistent right coronary artery aneurysm with proximal obstruction.
• Computed tomography angiography confirmed the coronary artery obstruction in the absence of symptoms.

Findings:

• Kawasaki disease can lead to long-term coronary artery complications, including aneurysms and obstruction, even in asymptomatic individuals.
• Coronary artery aneurysms may exhibit varied regression or persistence patterns over time.
• Right coronary artery aneurysms demonstrated a higher propensity for persistent obstruction in this case.

Implications:

• Long-term surveillance of Kawasaki disease patients with coronary aneurysms is essential for detecting potentially serious complications.
• Echocardiography alone may be insufficient for fully assessing coronary artery stenosis or obstruction.
• Advanced imaging techniques like computed tomography angiography and magnetic resonance angiography are vital adjuncts for comprehensive follow-up in KD patients with coronary aneurysms.