title: Cardiac Complications in 38 Cases of Kawasaki Disease with Coronary Artery Aneurysm Diagnosed by Echocardiography.
abstract: BACKGROUND
  The long-term prognosis of patients with Kawasaki disease (KD) complicated by coronary artery aneurysm (CAA) is unclear. The aim of this study was to evaluate the complications of KD with CAAs.
  
  
  METHODS
  We retrospectively analyzed the clinical data and complications of 38 KD patients with CAAs who were treated and underwent regular follow-up with echocardiography between January 1989 and May 2013.
  
  
  RESULTS
  During a period of 29 days to 19 years after disease onset, complications seen included coronary stenosis and occlusion (six patients), thrombosis (17 patients), myocardial infarction (six patients), and calcification of CAAs (seven patients). Rupture of giant CAAs occurred in two patients and caused sudden death in one of these patients at 29 days and in the other patient at 5 months after disease onset. A total of seven deaths occurred, with five deaths caused by myocardial infarction. Three of these had undiagnosed incomplete KD or had not received regular treatment, while two experienced sudden death after several asymptomatic myocardial infarctions.
  
  
  CONCLUSIONS
  Cardiac complications of KD with CAAs include thrombosis, coronary stenosis, myocardial infarction, sudden death, and calcification. Although rare, rupture of giant CAAs is fatal and might occur earlier after the onset of disease. Mortality occurred primarily in the earlier cases when anticoagulant therapy was insufficient and in patients who did not receive regular treatment. Echocardiography can provide reliable information for assessing the progression and prognosis of this condition.
authors.affiliation: Department of Ultrasound, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
authors.forename: Ya Juan
authors.initials: YJ
authors.lastname: Wei
authors.affiliation: Department of Ultrasound, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
authors.forename: Xiao Lan
authors.initials: XL
authors.lastname: Zhao
authors.affiliation: Department of Ultrasound, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
authors.forename: Bao Min
authors.initials: BM
authors.lastname: Liu
authors.affiliation: Department of Ultrasound, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Niu
authors.affiliation: Department of Ultrasound, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
mesh_terms: D000293:Adolescent; D002318:Cardiovascular Diseases / Q000401:mortality*; D015984:Causality; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality*; D004452:Echocardiography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging / Q000401:mortality*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D055815:Young Adult
keywords: Kawasaki disease; children; complication; coronary aneurysms; echocardiography; follow-up