Cardiac Arrest During Exertion as a Presentation of Undiagnosed Kawasaki Disease: A Case Report
Justyna Zamojska1, Piotr Kędziora1, Agnieszka Januś1
1Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, 91-738 Lodz, Poland.
Insights
Untreated Kawasaki disease can lead to coronary artery aneurysms, potentially causing sudden cardiac arrest in young adults. This case highlights the importance of considering KD complications in cardiac arrest diagnoses.
Area of Science:
- Cardiology
- Pediatric Rheumatology
Background:
- Kawasaki disease (KD) is a self-limited vasculitis affecting children.
- Untreated KD can lead to coronary artery aneurysms in 15-25% of cases.
- Coronary aneurysms may remain asymptomatic, presenting later with severe cardiac events.
Observation:
- A 17-year-old male presented with sudden cardiac arrest.
- Initial diagnostics ruled out channelopathies, structural defects, drug abuse, and myocardial infarction.
Findings:
- Coronary angiography and CT angiogram revealed a ruptured, clotted, calcified aneurysm of the left anterior descending artery.
- Collateral circulation suggested a long-standing issue, likely untreated Kawasaki disease from childhood.
Implications:
- Kawasaki disease complications should be considered in the differential diagnosis of sudden cardiac arrest in young individuals.
- This case underscores the critical need for timely KD diagnosis and management to prevent long-term cardiovascular sequelae.
Abstract:
Background: Kawasaki Disease (KD) is self-limited vasculitis, the main consequence of which may be involvement of the coronary arteries, especially in patients without treatment. It is estimated that coronary artery aneurysms occur in 15% to 25% of untreated children. Patients with coronary aneurysms may remain asymptomatic for years. The first symptom may be life-threatening sudden cardiac arrest or myocardial ischaemia. Methods: We report a case of a 17-year-old boy with an insignificant past medical history who presented with sudden cardiac arrest. Results: During diagnostics, channelopathies, structural heart defects, drug abuse, and myocardial infarction were excluded. The patient underwent coronary angiography, confirmed by CT angiogram of the coronary vessels, which revealed most likely ruptured, clotted, well-calcified aneurysm of the left anterior descending artery (LAD) with collateral circulation, probably a consequence of untreated Kawasaki disease in early childhood. Conclusions: Complications of KD should be considered in the differential diagnosis of sudden cardiac arrest, especially in a young person.
More Related Videos
08:19Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs
Published on: July 12, 2022
06:39Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:23Rheumatic Heart Disease I: Introduction
01:27Myocarditis II: Clinical features and Diagnostic Tests
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:28Mechanism of Cardiac Arrhythmias