Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-27T10:40:29.877Z Has data issue: false hasContentIssue false

Rare case of Kawasaki disease with cardiac tamponade and giant coronary artery aneurysms

Published online by Cambridge University Press:  11 February 2021

Andrea Vergara*
Affiliation:
Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy Department of Cardiology, Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, Caserta, Italy
Emanuele Monda
Affiliation:
Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
Cinzia Mautone
Affiliation:
Division of Pediatrics, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
Francesca Renon
Affiliation:
Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
Antonio Di Masi
Affiliation:
Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
Mario Giordano
Affiliation:
Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy Department of Cardiology, Division of Pediatric Cardiology, A.O.R.N. dei Colli, Monaldi Hospital, Naples, Italy
Giuseppe Limongelli
Affiliation:
Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart Department of Cardiovascular Sciences, University College of London and St. Bartholomew’s Hospital, London, UK
Paolo Calabrò
Affiliation:
Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy Department of Cardiology, Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, Caserta, Italy
Giovanbattista Capozzi
Affiliation:
Department of Cardiology, Division of Pediatric Cardiology, A.O.R.N. dei Colli, Monaldi Hospital, Naples, Italy
Maria G. Russo
Affiliation:
Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy Department of Cardiology, Division of Pediatric Cardiology, A.O.R.N. dei Colli, Monaldi Hospital, Naples, Italy
*
Author for correspondence: Dr A. Vergara, MD, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, 80131, Italy. Tel: +393339358442; Fax: +390817062815. E-mail: andreavergara2712@gmail.com

Abstract

Kawasaki disease is an acute systemic vascular disease, generally self-limited and typically affecting children <5 years old, which leads to coronary artery aneurysms in about 25% of untreated cases. Cardiovascular involvement is characterised by transient pancarditis, in acute phase, while coronary illness, ranging from mild dilation to giant CAAs occurs late, rarely before the 10th day since fever onset. Here, we describe a peculiar case of KD, which occurred in a 4-month-old infant and presented with exudate cardiac tamponade and early giant aneurism of both the proximal right coronary artery) and the left circumflex coronary artery, in acute phase of the disease.

Type
Brief Report
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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.)

References

McCrindle, BW, Rowley, AH, Newburger, JW, et al. American heart association rheumatic fever, endocarditis, and kawasaki disease committee of the council on cardiovascular disease in the young; council on cardiovascular and stroke nursing; council on cardiovascular surgery and anesthesia; and council on epidemiology and prevention. Diagnosis, treatment, and long-term management of kawasaki disease: a scientific statement for health professionals from the american heart association. Circulation 2017; 135: e927e999.Google Scholar
Liu, YC, Lin, MT, Wang, JK, Wu, MH. State-of-the-art acute phase management of Kawasaki disease after 2017 scientific statement from the American Heart Association. Pediatr Neonatol 2018; 59: 543552.CrossRefGoogle ScholarPubMed
Dahlem, PG, von Rosentiel, IA, Lam, J, Kuijpers, WT. Pulse methylprednisolone therapy for impeding cardiac tamponade in immunoglobulin-resistant Kawasaki disease. Intensive Care Med 1999; 25: 11371139.10.1007/s001340051025CrossRefGoogle Scholar
Friedman, KG, Gauvreau, K, Hamaoka-Okamoto, A, et al. Coronary artery aneurysms in Kawasaki disease: risk factors for progressive disease and adverse cardiac events in the US population. J Am Heart Assoc 2016; 5: e003289.10.1161/JAHA.116.003289CrossRefGoogle ScholarPubMed
Chantepie, A, Mauran, P, Lusson, JR, Vaillant, MC, Bozio, A. Cardiovascular complications of Kawasaki syndrome: results of a French multicenter study. Arch Pediatr 2001; 8: 713719.CrossRefGoogle ScholarPubMed
Kuppuswamy, M, Gukop, P, Sutherland, G, Venkatachalam, C. Kawasaki disease presenting as cardiac tamponade with ruptured giant aneurysm of the right coronary artery. Interact Cardiovasc Thorac Surg 2010; 10: 317318.10.1510/icvts.2009.215731CrossRefGoogle ScholarPubMed
Imai, Y, Sunagawa, K, Ayusawa, M, et al. A fatal case of ruptured giant coronary artery aneurysm. Eur J Pediatr 2006; 165: 130133.CrossRefGoogle ScholarPubMed
Maresi, E, Passantino, R, Midulla, R, et al. Sudden infant death caused by a ruptured coronary aneurysm during acute phase of atypical Kawasaki disease. Hum Pathol 2001; 32: 14071409.CrossRefGoogle ScholarPubMed
Takahashi, M, Mason, W, Lewis, AB. Regression of coronary aneurysms in patients with Kawasaki syndrome. Circulation 1987; 75: 387394.CrossRefGoogle ScholarPubMed