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STATE-OF-THE-ART PAPER

When Children With Kawasaki Disease Grow Up

Myocardial and Vascular Complications in Adulthood

John B. Gordon, MD^_*,_*, Andrew M. Kahn, MD, PhD and Jane C. Burns, MD

^_* San Diego Cardiac Center, San Diego, California
Department of Medicine, University of California San Diego School of Medicine and Rady Children's Hospital, San Diego, California
Department of Pediatrics, University of California San Diego School of Medicine and Rady Children's Hospital, San Diego, California

Manuscript received August 25, 2008; revised manuscript received March 25, 2009, accepted April 17, 2009.

^_* Reprint requests and correspondence: Dr. John B. Gordon, San Diego Cardiac Center, 3131 Berger Street, Suite 200, San Diego, California 92123 (Email: AdultKD{at}gmail.com).

Kawasaki disease (KD) is an acute, self-limited vasculitis that typically occurs in young children and was first described by Japanese pediatrician Tomisaku Kawasaki in 1967. Although originally thought to be a rare condition, KD has become the most common cause of acquired heart disease in the pediatric age group in developed countries. The majority of patients with KD appear to have a benign prognosis, but a subset of patients with coronary artery aneurysms are at risk for ischemic events and require lifelong treatment. In the 4 decades that have passed since the initial recognition of KD, the number of patients reaching adulthood has continued to grow. Adult cardiologists will be increasingly involved in the management of these patients. Currently, there are no established guidelines for the evaluation and treatment of adult patients who have had KD. We review here the current literature that may be helpful to clinicians who care for adults who experienced KD in childhood.

Key Words: aneurysm • vasculitis • myocardial infarction • myocardial flow reserve • myocarditis

Abbreviations and Acronyms   AHA = American Heart Association   CT = computed tomography   IMT = intimal medial thickness   IVIG = intravenous immunoglobulin   KD = Kawasaki disease   LOE = Level of Evidence   MR = magnetic resonance   SMR = standardized mortality ratio

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