Management of severe coronary sequelae of Kawasaki disease

Thirty-four patients with severe coronary sequelae of Kawasaki disease were prospectively investigated. Complications included giant coronary aneurysm (15 patients), coronary obstruction (11), stenosis (2) and surgical patients (6). The patients had been managed for four years according to our own f...

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Bibliographic Details
Published in:	The American heart journal Vol. 131; no. 3; pp. 576 - 581
Main Authors:	Tatara, Katsunori, Murata, Mitunori, Itoh, Keiko, Kazuma, Norio, Kondo, Chisato
Format:	Journal Article
Language:	English
Published:	New York, NY Mosby, Inc 01-03-1996 Elsevier
Subjects:	Acute Disease Adolescent Biological and medical sciences Child Combined Modality Therapy Coronary Disease - diagnosis Coronary Disease - etiology Coronary Disease - pathology Coronary Disease - therapy Female Follow-Up Studies Humans Male Medical sciences Mucocutaneous Lymph Node Syndrome - complications Mucocutaneous Lymph Node Syndrome - diagnosis Mucocutaneous Lymph Node Syndrome - pathology Mucocutaneous Lymph Node Syndrome - therapy Prognosis Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Sonography Human Kawasaki syndrome Immunopathology Echocardiography Radiodiagnosis Angiography Cardiovascular disease Autoimmune disease Exploration Vascular disease Electrodiagnosis Vasculitis Systemic disease Electrocardiography Exercise tolerance test
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Summary:	Thirty-four patients with severe coronary sequelae of Kawasaki disease were prospectively investigated. Complications included giant coronary aneurysm (15 patients), coronary obstruction (11), stenosis (2) and surgical patients (6). The patients had been managed for four years according to our own follow-up schedule in which we carried out for example treadmill stress tests two or three times a year and myocardial imaging once a year. One patient died after surgery during the observation period while jogging at school. Although his bypass grafts were patent, treadmill tests and myocardial imaging revealed that he had ischemia. Five patients were newly diagnosed with ischemia by treadmill tests and myocardial imaging, and all underwent bypass surgery. Even after successful surgery, it was necessary to wait for normal ischemic findings in some patients. We conclude that serial treadmill stress tests and myocardial imaging are mandatory in managing severe coronary sequelae of Kawasaki disease. Restriction of daily activity and exercise is also necessary after diagnosis of ischemia by treadmill tests.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0002-8703 1097-6744
DOI:	10.1016/S0002-8703(96)90539-6