When Children With Kawasaki Disease Grow UpMyocardial 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
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Figure 1 Sequential Angiographic Evaluation During a 10- to 21-Year-Period of Japanese Patients With KD Who Developed Coronary Artery Aneurysms
F/u = follow-up; KD = Kawasaki disease; MI = myocardial infarction.
Adapted, with permission, from Kato et al. (3).
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Figure 2 Histology of Kawasaki Disease
Autopsy findings in a 19-year-old man who developed severe cardiomyopathy 17 years after Kawasaki disease at age 2 years treated with intravenous immunoglobulin. Echocardiography during the acute and convalescent phase showed normal internal dimensions of the coronary arteries. (A) Masson trichrome stain of a branch of the right coronary artery showing late organization of a thrombus. Original magnification x40. (B) Masson trichrome stain of left ventricle showing endocardial fibrosis with an organizing subendocardial microinfarct. Original magnification x100.
Photos courtesy of Dr. Henry F. Krous, Director of Pathology Research, Rady Children's Hospital, San Diego, California.
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Figure 3 Calcification of Coronary Artery
Multislice computed tomography angiogram showing extensive calcification of a left anterior descending coronary artery aneurysm in a 12-year-old male patient 7 years after acute Kawasaki disease.
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Figure 4 Occlusion of the RCA
Angiogram of occluded right coronary artery (RCA) aneurysm in a 33-year-old man who experienced a Kawasaki disease-compatible illness at age 6 years (diagnosed as nonspecific viral illness) and was asymptomatic until his myocardial infarction. (A) Injection of the occluded RCA (B) RCA after percutaneous transluminal coronary angioplasty with re-established distal flow. Note smooth appearance of distal branches of the RCA. (C) Patent RCA aneurysm 1 month after percutaneous transluminal coronary angioplasty, aspirin, and warfarin therapy maintaining an international normalized ratio of 2 to 2.5.
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