Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T07:03:47.915Z Has data issue: false hasContentIssue false
  • English
  • Français

Ruptured mitral valves chordae tendineae around a convalescent infant with acute Kawasaki disease

Published online by Cambridge University Press:  26 October 2018

Etsuko Tsuda ,
Jun Negishi ,
Hikari Miike  and
Kenichi Kurosaki
Etsuko Tsuda*
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Jun Negishi
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Hikari Miike
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Kenichi Kurosaki
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
*
Author for correspondence: E. Tsuda, Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita-shi, Osaka 565-8565, Japan. Tel: 81-6-6833-5012; Fax: 81-6-6872-7486; E-mail: etsuda@ncvc.go.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Severe valvulitis owing to acute Kawasaki disease leading to severe mitral regurgitation is a rare event in infants. Further, there is less information about underlying ruptured mitral chordae tendineae causing severe mitral regurgitation. We encountered ruptured mitral chordae tendineae in three female patients after Kawasaki disease. The age at the onset of Kawasaki disease ranged from 3 to 8 months, and detection of ruptured mitral chordae tendineae was from 24 to 90 days. Two patients had acute heart failure, and one was asymptomatic. One patient underwent mitral annuloplasty, and the others responded to medication. These ruptured mitral chordae tendineae occurred after the remission of the initial acute Kawasaki disease, in the early course and the convalescent of acute Kawasaki disease. Further, the recurrent fever was also detected in them. The ruptured mitral chordae tendineae in an infant within 6 months can be detected by systolic heart murmur around the convalescent stage of acute Kawasaki disease, although the prevalence is very low.

Keywords

Kawasaki diseaseruptured mitral chordae tendineaeacute heart failuremitral regurgitation
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 1 , January 2019 , pp. 30 - 35
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Cite this article: Tsuda E, Negishi J, Miike H, Kurosaki K. (2018) Ruptured mitral valves chordae tendineae around a convalescent infant with acute Kawasaki disease. Cardiology in the Young29: 30–35. doi: 10.1017/S1047951118001646

References

1. Suzuki, A, Kamiya, T, Tsuchiya, K, et al. Tricuspid and mitral regurgitation detected by color flow Doppler in the acute phase of Kawasaki disease. Am J Cardiol 1988; 61: 386–390.Google Scholar
2. Akagi, T, Kato, H, Inoue, O, Toyoda, O, Sato, N, Imamura, K. Valvular heart disease in Kawasaki disease: Incidence and natural history. Am Heart J 1990; 120: 366–372.Google Scholar
3. Kitamura, S, Kawashima, Y, Kawachi, K, et al. Severe mitral regurgitation due to coronary arteritis of mucocutaneous lymph node syndrome. a new surgical entity. J Thorac Cardiovasc Surg 1980; 80: 629–636.Google Scholar
4. Imakita, M, Sasaki, Y, Misugi, K, Miyazawa, Y, Hyodo, Y. Kawasaki disease complicated with mitral insufficiency. Autopsy findings with special reference to valvular lesion. Acta Pathol Jpn 1984; 34: 605–616.Google Scholar
5. Sawada, H, Tsuda, E, Ono, Y, et al. Two cases with severe mitral regurgitation due to ruptured chordae tendineae in patients with Kawasaki disease. Prog Med 1997; 17: 1729–1734 (in Japanese).Google Scholar
6. Shiraishi, I, Nishimura, K, Sakaguchi, H, et al. Acute rupture of chordae tendineae of the mitral valve in infants. A nationwide survey in Japan exploring a new syndrome. Circulation 2014; 130: 1053–1061.Google Scholar
7. Tsuda, E, Uchiyama, T, Abe, T. Management of acute myocardial dysfunction with disturbed consciousness due to Kawasaki disease. Pediatr Intern 2012; 54: e10–e14.Google Scholar
8. Fujiwara, H, Hamashima, Y. Pathology of the heart in Kawasaki disease. Pediatrics 1978; 62: 100–107.Google Scholar
9. Takechi, T, Tani, Y, Ozaki, M, et al. Sequelae mitral regurgitation and myocardial damage in a case of Kawasaki disease with early regression of coronary aneurysms. Prog Med 1988; 11: 1743–1749 (in Japanese).Google Scholar
10. Tomita, H, Sawada, Y, Higashide, Y, Chiba, S, Ito, S, Kogasaki, R. Mitral regurgitation with gross deformity of a mitral leaflet due to Kawasaki disease. Pediatr Cardiol 1990; 11: 153–155.Google Scholar
11. Mishima, A, Asano, M, Saito, T, et al. Mitral regurgitation caused by ruptured chordae tendineae in Kawasaki disease. J Thorac Cardiovasc Surg 1996; 111: 895–896.Google Scholar
12. Haniu, H, Kitano, M, Kurosaki, K, Watanabe, K, Tsuda, E, Echigo, S. Endocarditis with bilateral conjunctival injection in a 6-month-old boy. Differential diagnosis of infective endocarditis versus atypical Kawasaki disease. A case report. Prog Med 2005; 25: 1773–1776; (in Japanese).Google Scholar
13. Fukuhara, H, Toyohara, K, Tazato, H, et al. An infantile case of atypical Kawasaki disease complicated with severe mitral insufficiency and treated with a prosthetic valve replacement. Prog Med 2005; 25: 1781–1786 (in Japanese).Google Scholar