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Clinical features in adults with coronary arterial lesions caused by presumed Kawasaki disease

Published online by Cambridge University Press:  23 January 2007

Etsuko Tsuda ,
Mai Matsuo ,
Hiroaki Naito ,
Teruo Noguchi ,
Hiroshi Nonogi  and
Shigeyuki Echigo
Etsuko Tsuda
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Osaka, Japan
Mai Matsuo
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Osaka, Japan
Hiroaki Naito
Affiliation:
Department of Radiology,* National Cardiovascular Center, Osaka, Japan
Teruo Noguchi
Affiliation:
Department of Cardiovascular Medicine, National Cardiovascular Center, Osaka, Japan
Hiroshi Nonogi
Affiliation:
Department of Cardiovascular Medicine, National Cardiovascular Center, Osaka, Japan
Shigeyuki Echigo
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Osaka, Japan
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Abstract

There exists a population of adults with undiagnosed coronary arterial lesions due to Kawasaki disease occurring before 1967. We report the clinical features in 6 adult males with coronary arterial lesions caused by presumed Kawasaki disease, whose dates of birth ranged from 1945 to 1963. The age of the diagnosed coronary arterial lesions due to presumed Kawasaki disease ranged from 26 to 48 years. In 4 patients, there was a history of probable Kawasaki disease. The presenting features were chest pain in 2; syncope in 1, an abnormal electrocardiogram in 2; a history of presumed Kawasaki disease in 1, and symptomatic myocardial infarction in the final patient. Coronary angiograms revealed multi-vessel disease in 5 patients, with segmental stenosis in 5, and calcified giant aneurysms in the proximal portion of the coronary arteries also in 5. Low left ventricular ejection fractions of less than 40% were found in 3. Of the patients, 3 had undergone coronary arterial bypass grafting. A defibrillator had been implanted in 2 because of rapid ventricular tachycardia with syncope induced during electrophysiologic studies. We conclude that, in patients with multi-vessel disease or left ventricular dysfunction caused by presumed Kawasaki disease, symptoms and serious cardiac events occur in adult life with the onset of ageing, although the patients had been asymptomatic for many years after the onset of Kawasaki disease itself.

Keywords

Coronary aneurysmcoronary arterial calcificarionatherosclerosisacute myocardial infarctionventricular tachycardiamucocutaneous lymph node syndrome
Type
Original Article
Information
Cardiology in the Young , Volume 17 , Issue 1 , February 2007 , pp. 84 - 89
Copyright
2007 Cambridge University Press

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References

Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children (in Japanese). Jpn J Allergy 1967; 164: 178–222.Google Scholar
Kato H, Inoue O, Kawasaki T, Fujiwara H, Watanabe T, Toshima H. Adult coronary artery disease probably due to childhood Kawasaki disease. Lancet 1992; 340: 1127–1129.Google Scholar
Suzuki A, Kamiya T, Tsuda E, Tsukano S. Natural history of coronary artery lesions in Kawasaki disease. Progr Pediatr Cardiol 1997; 6: 211–218.Google Scholar
Tsuda E, Kamiya T, Kimura K, Ono Y, Echigo S. Coronary artery dilatation exceeding 4.0 mm during acute Kawasaki disease predicts a high probability of subsequent late intima-medial thickening. Pediatr Cardiol 2002; 23: 9–14.Google Scholar
Hirota M, Tsuda E, Kurosaki K, Echigo S, Tagusari O, et al. Muttiple giant coronary aneurysms with calcification: Athero-sclerosis and coronary artery lesions due to Kawsaki disease compared by electron beam computed tomography. A case report. Prog Med 2004; 24: 1689–1693 (in Japanese).Google Scholar
Kanamaru H, Sato Y, Takayama T, et al. Assessment of coronary artery abnormalities by multislice spiral computed tomography in adolescents and young adults with Kawasaki disease. Am J Cardiol 2005; 95: 522–525.Google Scholar
Tsuda E, Arakaki Y, Shimizu T, et al. Changes in causes of sudden death by decade in patients with coronary arterial lesions due to Kawasaki disease. Cardiol Young 2005; 15: 481–488.Google Scholar
Yagi S, Tsuda E, Shimizu W, et al. Two adults requiring implantable defibrillators because of ventricular tachycardia and left ventricular dysfunction caused by presumed Kawasaki disease. Circ J 2005; 69: 870–874.Google Scholar
Burns JC, Shike H, Gordon JB, Malhotra A, Schoenwetter M, Kawasaki T. Sequelae of Kawasaki disease in adolescents and young adults. JACC 1996; 28: 253–257.Google Scholar
Parisi Q, Abbate A, Biondi-Zoccai G, Spina D, Savino M, Burzotta F. Clinical manifestations of coronary aneurysms in the adults as possible sequelae of Kawasaki disease during infancy. Acta Cardiol 2004; 59: 5–9.Google Scholar
Wreford FS, Conradi SE, Cohle SD, Lie JT, Dana SE, Puri S. Sudden death caused by coronary artery aneurysms: A late complication of Kawasaki disease. JFSCA 1991; 36: 51–59.Google Scholar
Kristensen IB, Kristensen BO. Sudden death caused by thrombosed coronary aneurysm. Two unusual cases of Kawasaki disease. Int J Leg Med 1994; 106: 277–280.Google Scholar
Rozin L, Koehler SA, Shakir A, Ladham S, Wecht CH. Kawasaki Disease. A Review of pathologic features of stage IV disease and two cases of sudden death among asymptomatic young adults. Am J Forensic Med Pathol 2003; 24: 45–50.Google Scholar
Negoro N, Nariyama J, Nakagawa A, et al. Successful catheter interventional therapy for acute coronary syndrome secondary to Kawasaki disease in young adults. Circ J 2003; 67: 362–365.Google Scholar