title: Presentation of missed childhood Kawasaki disease in adults: Experience from a tertiary care center in north India.
abstract: OBJECTIVE
  Kawasaki disease (KD) is the most common cause of acquired heart disease in children in Japan, North America and Europe. Undiagnosed and untreated KD can have clinically significant consequences later in life. The clinical spectrum of missed childhood KD is frequently being recognized during adulthood. We report four adult cases of acute coronary events, in which coronary angiography was suggestive of sequelae of KD.
  
  
  METHODS
  Four adults who presented with acute coronary events, had coronary angiography for evaluation. Indoor-admission files were analyzed for the clinical details of individual cases.
  
  
  RESULTS
  Two cases were below 40 years of age. None of the patients had any known conventional risk factors for atherosclerosis. Case 4 had a clinical history of childhood KD. Coronary angiography revealed ectasia of multiple coronary arteries and stenosis in distal segments in the first three cases and large thrombosed aneurysm with calcified walls in the fourth case.
  
  
  CONCLUSIONS
  We hereby report four adult cases with acute coronary events, who had markedly dilated coronary artery segments suggestive of possible sequelae of childhood KD.
authors.affiliation: Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Vijayvergiya
authors.affiliation: Pediatric Allergy and Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sagar
authors.identifier: http://orcid.org/0000-0002-5048-9727
authors.initials: S
authors.lastname: Bhattad
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Subhash
authors.initials: S
authors.lastname: Varma
authors.affiliation: Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Manphool
authors.initials: M
authors.lastname: Singhal
authors.affiliation: San Diego Cardiac Centre and Sharp Memorial Hospital, San Diego, CA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Gordon
authors.affiliation: Pediatric Allergy and Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Surjit
authors.initials: S
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D057210:Delayed Diagnosis; D006801:Humans; D007194:India; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D011237:Predictive Value of Tests; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000209:etiology
chemical_list: D002317:Cardiovascular Agents
keywords: Kawasaki disease; adults; aneurysm; atherosclerosis; dilated coronaries