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Cardiac Complications in 38 Cases of Kawasaki Disease with Coronary Artery Aneurysm Diagnosed by Echocardiography
Author(s) -
Wei Ya Juan,
Zhao Xiao Lan,
Liu Bao Min,
Niu Hua,
Li Qian
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13154
Subject(s) - kawasaki disease , medicine , cardiology , aneurysm , coronary artery aneurysm , coronary artery disease , artery , radiology
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 CAA s. Method We retrospectively analyzed the clinical data and complications of 38 KD patients with CAA s 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 CAA s (seven patients). Rupture of giant CAA s 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. Conclusion Cardiac complications of KD with CAA s include thrombosis, coronary stenosis, myocardial infarction, sudden death, and calcification. Although rare, rupture of giant CAA s 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.