Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-17T15:19:35.015Z Has data issue: false hasContentIssue false
  • English
  • Français

Cardiac events in Patients in their forties with Kawasaki disease and regression of coronary artery aneurysms

Published online by Cambridge University Press:  11 September 2020

Etsuko Tsuda Open the ORCID record for Etsuko Tsuda [Opens in a new window] ,
Shuichi Yoneda ,
Yasuhide Asaumi  and
Atsuko Suzuki
Etsuko Tsuda*
Affiliation:
Department of Paediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Shuichi Yoneda
Affiliation:
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
Yasuhide Asaumi
Affiliation:
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
Atsuko Suzuki
Affiliation:
Department of Paediatrics, Tokyo Teishin Hospital, Tokyo, Japan
*
Author for correspondence: Etsuko Tsuda, Department of Paediatric Cardiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita-shi, Osaka564-8565, Japan. Tel: +81 6 6170 1070; fax: +81 6 6170 1748. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Over a 50-year period from the first description of Kawasaki disease, we encountered three male patients with a history of Kawasaki disease, who had their first cardiac events in their forties. They were considered to have almost normal coronary arteries in the coronary angiograms when they were children and adolescents. They had no follow-up examinations after 20 years old. The 1st patient had an acute myocardial infarction, and the 2nd was a new appearance of coronary aneurysm and stenotic lesions with coronary artery calcification. The 3rd patient had unexpected sudden death. The interval from the onset of Kawasaki disease to the cardiac events ranged from 37 to 38 years. In the former two patients, coronary artery lesions could not be evaluated immediately after Kawasaki disease. Although the 3rd patient had bilateral medium-sized coronary artery aneurysms, his coronary aneurysms regressed 1 year after acute Kawasaki disease. The intimal thickening at a previous coronary aneurysm at the age of 19 was mild. The patients with regressed coronary aneurysms were asymptomatic for about 40 years after Kawasaki disease, prior to their cardiac events. Coronary artery calcification of the proximal portion of the major coronary arteries was a predictable marker in such patients. To prevent serious cardiac events in middle-aged adult patients, reevaluation of coronary artery lesions and restarting of anti-thrombotic therapy are needed. We must be aware that there are some differences in the clinical course and time of cardiac events between patients with giant aneurysms and those with medium aneurysms.

Keywords

Kawasaki diseasecoronary artery aneurysmregressioncoronary artery calcificationcardiac events
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 12 , December 2020 , pp. 1821 - 1825
Check for updates
Copyright
© The Author(s), 2020. 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

Tsuda, E, Tsujii, N, Hayama, Y. Stenotic lesions and the maximum diameter of coronary artery aneurysms in Kawasaki disease. J Pediatr. 2018; 194: 165–170.CrossRefGoogle ScholarPubMed
Tsuda, E, Kamiya, T, Ono, Y, Kurosaki, K, Echigo, S. Incidence of stenotic lesions predicted by acute phase changes in coronary arterial diameter during Kawasaki Disease. Pediatr Cardiol. 2005; 26: 73–79.CrossRefGoogle ScholarPubMed
Tsuda, E, Hamaoka, K, Suzuki, H, et al. A survey of the 3-decade outcome for patients with giant aneurysms caused by Kawasaki disease. Am Heart J. 2014; 167: 249–258.CrossRefGoogle ScholarPubMed
Suzuki, A, Kamiya, T, Tsuda, E, Tsukano, S. Natural history of coronary artery lesions in Kawasaki disease. Prog Pediatr Cardiol. 1997; 6: 211–218.CrossRefGoogle Scholar
Suzuki, A, Yamagishi, M, Kimura, K, et al. Functional behavior and morphology of the coronary artery wall in patients with Kawasaki disease assessed by intravascular ultrasound. J Am Coll Cardiol. 1996; 27: 291–296.CrossRefGoogle ScholarPubMed
Tsuda, E. The coronary arterial wall imaging by intravascular ultrasound in Kawasaki disease. Advanced technology in Cardiology. Res. Adv. Cardiol. 2, 2003; 21–28.Google Scholar
Suzuki, A, Miyagawa, S, Komatsu, K, et al. Active remodeling of the coronary arterial lesions in the late phase of Kawasaki disease. Immunohistochemical study. Circulation. 2000; 101: 2935–2941.CrossRefGoogle ScholarPubMed
Tsuda, E, Matsuo, M, Kurosaki, K, et al. Clinical features of patients diagnosed as coronary artery lesions caused by presumed Kawasaki disease in adult. Cardiol Young. 2007; 17 (1): 84–89.CrossRefGoogle Scholar
Kahn, AM, Budoff, MJ, Duniels, LB, et al. Usefulness of calcium scoring as a screening examination in patients with a history of Kawasaki disease. Am J Cardiol. 2017; 119: 967–971.CrossRefGoogle ScholarPubMed
Tsujii, N, Tsuda, E, Kanzaki, S, Ishiduka, J, Nakashima, K, Kurosaki, K. Late wall thickening and calcification after Kawasaki disease. J Pediatr. 2017; 181: 167–171.CrossRefGoogle ScholarPubMed
Tsuda, E, Arakaki, Y, Shimizu, T, et al. Changes on causes of sudden deaths in patients with coronary arterial lesions due to Kawasaki disease. Cardiol Young. 2005; 15: 1–8.CrossRefGoogle ScholarPubMed
Suda, K, Iemura, M, Nishiono, H, et al. Long-term prognosis of patients with Kawasaki disease complicated by giant coronary aneurysms: a single-institution experience. Circulation. 2011: 123 (17): 1836–1842.CrossRefGoogle ScholarPubMed
Tsuda, E, Tsujii, N, Hayama, Y. Cardiac events and the maximum diameter of coronary artery aneurysms in Kawasaki disease. J Pediatr. 2017; 188: 70–74.CrossRefGoogle ScholarPubMed
Gordon, JB, Daniels, LB, Kahn, AM, et al. The spectrum of cardiovascular lesions requiring intervention in adults after Kawasaki disease. JACC, Cardiovasc Interventions. 2015; 9: 687–696.CrossRefGoogle Scholar
Mitani, Y, Tsuda, E, Kato, H, et al. Emergence and characterization of acute coronary syndrome in adults after confirmed or missed history of Kawasaki disease in Japan: A Japanese nationwide survey. Front Pediatr. 2019; 7: 275.https://doi.org/10.3389/fped.2019.00275 CrossRefGoogle ScholarPubMed
Tsuda, E, Abe, T, Tamaki, W. Acute coronary syndrome in adult patients with coronary artery lesions caused by Kawasaki disease: review of case reports. Cardiol Young. 2011; 21: 74–82.CrossRefGoogle ScholarPubMed
Kawai, H, Takakura, Y, Naruse, H, et al. Two cases with past Kawasaki disease developing acute myocardial infarction in their thirties, despite being regarded as at kl low risk for coronary events. Heart Vessels. 2015; 30: 549–553.CrossRefGoogle Scholar
Tsuda, E, Kamiya, T, Ono, Y, Kimura, K, Echigo, S. Dilated coronary arterial lesions in the late period after Kawasaki disease. Heart 2005; 91: 177–182.CrossRefGoogle ScholarPubMed
Ozawa, S, Suzuki, H, Hasegawa, S, et al. Two cases of new coronary aneurysms that developed in the late period after Kawasaki disease. Pediatr Cardiol. 2013; 34: 1992–1995.CrossRefGoogle ScholarPubMed