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Visualization of the coronary arterial lesions in Kawasaki disease by coronary angiography

Published online by Cambridge University Press:  19 August 2008

Atsuko Suzuki  and
Tetsuro Kamiya
Atsuko Suzuki*
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Osaka
Tetsuro Kamiya
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Osaka
*
Dr. Atsuko Suzki, Department of Pediatrics, National Cardiovascular Center, 5-1 Fujishirodai Suitashi, Osaka 565, Japan
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Summary

Formation of coronary aneurysms is often seen on the patients in the acute phase of Kawasaki disease by echocardiography, and after the convalescent phase, some patients show disappearance of aneurysms but some of them show combining stenotic lesions at inlets and/or outlets of aneurysms on coronary arteriography. According to follow-up studies of coronary arterial lesions, the degree of stenosis quite frequently increases and progresses over a period up to 10 years or more after the onset of the disease. The severe stenosis appears the most frequently at the proximal portion of the left anterior descending artery and secondly at the main trunk of the main coronary artery. They die suddenly or suffer from severe myocardial infarction unless they are treated with aortocoronary bypass surgery. However, it is rare to have symptoms of ischemic heart disease even in patients with severe obstructive lesions. In fact, the sensitivity of exercise testing in diagnosis of myocardial ischemia is very low. Dipyridamole thallium myocardial imaging is reasonably useful, but dipyridamole can he dangerous when it is given without the precise information of the patient's stenosis. Coronary arteriography is, therefore, essential not only to determine the appropriate treatment of the c ronary arterial lesions but also for follow-up. According to the histopathologic study, even the patients in whom coronary arterial lesions were not visualized on coronary arteriography often show some intimal proliferation. These patients may well present a problem in the future due to the sequels of angiitis. Because of this, continuous regular follow-up should be necessary, even in patients with no evidence of coronary arterial lesion.

Type
The World Forum for Pediatric Cardiology Symposium on Kawasaki Disease
Information
Cardiology in the Young , Volume 1 , Issue 3 , July 1991 , pp. 225 - 233
Copyright
Copyright © Cambridge University Press 1991

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References

1.Suzuki, A, Kamiya, TOno, Y, Kohata, T, Okuno, M. Myocar dial ischemia in Kawasaki disease: Follow-up study by cardiac catheterization and coronary angiography. Pediatr Cardiol 1988; 9: 1–5.CrossRefGoogle Scholar
2.Suzuki, A. Diagnosis of cardiac manifestations of Kawasaki disease. In: Okuni, M, Naoe, S, Asai, T eds. Handbook of Kawasaki Disease. Cyugaiigajusya, Tokyo, 1988, pp 73–85. [Japanese]Google Scholar
3.Suzuki, A. Standardization of echocardiographic findings of coronary artery lesions due to Kawasaki disease. Pediatrics Book: special number 1. Kanehara, Tokyo, 1986 160–170. [Japanese]Google Scholar
4.Kamiya, T, Suzuki, A, Kimura, Y, Hirose, O, Takahashi, O. Coronary arterial lesions in Kawasaki disease-occurrence and prognosis. Rec Adv Cardiovasc Dis 1982; 3: 19–27. [Japanese]Google Scholar
5.Suzuki, A, Kamiya, T, Ono, Y, Kohata, T, Kimura, K, Takamiya, M. Follow-up study ofcoronary artery lesions due to Kawasaki disease by serial selective coronary arteriography in 200 pa tients. Heart Vessels 1987; 3: 159–165.CrossRefGoogle Scholar
6.Suzuki, A, Kamiya, TOno, Y, Okuno, M, Yagihara, M. Aortocoronary bypass surgery for coronary arterial lesions due to Kawasaki disease. J Pediatr 1990; 114: 567–573.CrossRefGoogle Scholar
7.Ono, Y, Tanimoto, T, Kijima, Y, Kohata, T, Suzuki, A, Kamiya, M, Nishimura, N, Kozuka, T. Myocardial imaging in patients with Kawasaki disease: exercise stress imaging and serial studies. J Cardiography 1982; 12: 387–399. [Japanese]Google ScholarPubMed
8.Kuroe, K, Kohata, T, Echigo, S, Suzuki, A, Kamiya, T, Naito, H, Saito, H, Takamiya, M. Myocardial imaging on ultra-fast computed tomography in patients with a history oi Kawasaki disease. Pro Med 1990; 10: 93–979.Google Scholar
9.Suzuki, A, Kamiya, T, Kuwahara, N, Ono, Y, Kohata, T, Takahashi, O, Kimura, K, Takamiya, M. Coronary arterial lesions of Kawasaki disease: cardiac catheterization findings of 1100 cases. Pediatr Cardiol 1986; 7: 3–9.CrossRefGoogle ScholarPubMed
10.Kamiya, T, Kawasaki, T, Okuni, M, Kato, H, Baba, K, Nakano, H. Report of subcommittee on standardization of diagnostic criteria and reporting of coronary artery lesions in Kawasaki disease. Ministry of Health and Welfare, Tokyo, 1983, pp 1–5.Google Scholar
11.Nakano, H, Nojima, K, Saito, A, Ueda, K. Grading of dilated lesion due to Kawasaki disease based on the findings of coro nary arteriography. J Jpn Pediatr Soc 1984; 88: 1275–1282. [Japanese]Google Scholar
12.Kato, H, Koike, S, Yamamoto, M, Ito, Y, Yano, E. Coronary aneurysms in infants and young children with acute febrile mucocutaneous lymph node syndrome. J Pediatr 1975; 86: 892–893.CrossRefGoogle ScholarPubMed
13.Masuda, H, Naoe, S, Tanaka, N. Pathological study ofcoronary artery in Kawasaki disease—with special reference to morpho genesis of aneurysm. J Jpn Coil Angiol 1981; 21: 899–912.Google Scholar
14.Yamada, K, Fukumoto, T, Shinkai, A, Shirahata, A, Meguro, T. The platelet function in acute febrile mucocutaneous lymph node syndrome and a trial of prevention for thrombosis by antiplatelet agent. Acta Haem Jpn 1978; 41: 791–802.Google Scholar
15.Kato, H, Ichinose, E, Kawasaki, T. Myocardial infarction in Kawasaki disease. Clinical analysis in 195 cases. J Pediatr 1986 108: 923–927.CrossRefGoogle ScholarPubMed
16.Tanimoto, T, Kamiya, T, Misawa, H, Manabe, H, Go, S. An autopsied case of an elementary schoolboy with sudden death four years after Kawasaki disease: on the problem of present method of cardiac mass screening of school children. Jpn Circulation J 1981; 45: 1438–1442.CrossRefGoogle Scholar
17.Niimi, H, Oka, S. Regional stress and deformation in an aneurysmal dilatation of arterioles. Microvasc Res 1980; 17:54.Google Scholar
18.Naoe, S, Masuda, H. Kawasaki disease as a risk factor ofjuvenile arteriosclerosis. J Jpn Atheroscler Soc 1981; 9: 27–31. [Japanese]Google Scholar
19.Fujiwara, T, Fujiwara, H, Nakano, H. Pathological feature of coronary arterial in children with Kawasaki disease in which coronary arterial aneurysms was absent at autopsy: quantita tive analysis. Circulation 1988; 78: 345–350.CrossRefGoogle Scholar
20.Iwata, H, Okuno, M, Ono, Y, Kohata, T, Suzuki, A, Kamiya, T, Fukushima, A, Arita, K. Prognosis of the cases with localized stenosis occurred from small aneurysms on the coronary angiography. Prog Med 1989; 9: 2019–2025,. [Japanese]Google Scholar