Grown-up Kawasaki disease patients who have giant coronary aneurysms.
BACKGROUND
Many Kawasaki disease (KD) patients have reached adulthood in Japan. The current status of adult patients who have giant coronary aneurysms with KD is not well understood.


METHODS
Medical records of 48 KD patients (33 males and 15 females) with giant coronary aneurysms (maximum coronary artery internal diameter >8 mm) aged 20 years or over were retrospectively reviewed.


RESULTS
The age of the patients at the diagnosis of KD ranged from 0.3 to 12.8 years (median 2.9 years) and the age of the patients in this review ranged from 20.0 to 33.1 years (median 25.2 years). During the follow-up period, the maximum coronary artery internal diameter ranged from 8.2 to 30.0 mm (median 10 mm). Giant coronary aneurysms progressed to coronary artery stenosis and/or complete occlusion in 34 (74%) of 46 patients. Coronary artery bypass graft surgery was performed in 9 (19%) of 48 patients. Myocardial infarction occurred in 14 (31%) of 45 patients. Other complications or problems occurred in 5 patients with angina pectoris, low left ventricular ejection fraction, ventricular tachycardia, hemorrhagic cerebral infarction, or thyroid carcinoma respectively. In the patients followed up, 4 dropped out. In addition, 1 patient succeeded in pregnancy and delivered a baby.


CONCLUSIONS
Close attention should be paid to ventricular tachycardia in adult KD patients with giant coronary aneurysms, especially for those who have low left ventricular ejection fraction. To reduce the number of dropped out patients, it is important that the patients should be referred to a new doctor when they change their place of residence.
Department of Pediatrics, Jichi Medical University, Tochigi, 329-0498, Japan. ksamada@jichi.ac.jp
Kazunori
K
Samada
Hirohiko
H
Shiraishi
Asami
A
Sato
Mariko Y
MY
Momoi
D000328:Adult; D000787:Angina Pectoris / Q000453:epidemiology; D020520:Brain Infarction / Q000453:epidemiology; D003323:Coronary Aneurysm / Q000453:epidemiology*; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D054059:Coronary Occlusion / Q000453:epidemiology; D023921:Coronary Stenosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000453:epidemiology*; D009203:Myocardial Infarction / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D013318:Stroke Volume; D017180:Tachycardia, Ventricular / Q000453:epidemiology; D013964:Thyroid Neoplasms / Q000453:epidemiology