Long-term cardiac sequelae of Kawasaki disease.
Kawasaki disease is the leading cause of acquired heart disease in childhood. Despite treatment with intravenous gamma globulin, 2% to 4% of patients have coronary abnormalities. Those with giant aneurysms are at risk for stenosis and myocardial ischemia/infarction, and require aggressive anticoagulation with frequent follow-up, including stress testing and coronary angiography. In rare cases, patients will have coronary artery bypass grafting. Those with less severe coronary involvement need antiplatelet therapy and infrequent noninvasive testing. Patients with normal echos after the acute phase are not treated, but the future impact of the disease is not certain particularly in the setting of adult onset coronary artery disease.
Fulton
D R
DR
Department of Cardiology, Children's Hospital of Boston, 300 Longwood Avenue, Boston, MA 02115, USA. Fulton@cardio.tch.harvard.edu
Newburger
J W
JW
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000209:etiology; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology; D004452:Echocardiography; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000175:diagnosis; D009203:Myocardial Infarction / Q000188:drug therapy / Q000209:etiology; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016756:Immunoglobulins, Intravenous; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin