Case Report: Late coronary complication of Kawasaki disease

Area of Science:

• Cardiology
• Pediatric Cardiology
• Vascular Medicine

Background:

• Kawasaki disease (KD) is a leading cause of acquired pediatric heart disease.
• KD can result in long-term cardiovascular sequelae, including coronary artery aneurysms and stenosis.
• Intravenous immunoglobulin (IVIG) is a standard treatment for KD.

Observation:

• A 17-year-old male with a history of KD at ages 3 and 8, treated with IVIG and presenting with a moderate right coronary aneurysm, reported exertional dyspnea and atypical chest pain.
• Routine electrocardiogram (ECG) and exercise stress tests yielded normal results.
• Advanced cardiac imaging revealed significant coronary artery stenosis.

Findings:

• Despite initial normal findings on routine cardiac evaluation, significant coronary artery stenosis was detected via advanced imaging.
• The patient required angioplasty to address the identified coronary stenosis.
• This case underscores the potential for late-onset coronary complications in KD survivors.

Implications:

• Standard diagnostic modalities like ECG and exercise tests may underestimate the severity of coronary artery disease in KD patients.
• Multimodal imaging approaches are essential for accurate assessment and management of cardiovascular complications in KD survivors.
• Tailored, long-term surveillance and management strategies are critical for patients with a history of Kawasaki disease.