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Clinical features in adults with coronary arterial lesions caused by presumed Kawasaki disease

Published online by Cambridge University Press:  23 January 2007

Etsuko Tsuda ,
Mai Matsuo ,
Hiroaki Naito ,
Teruo Noguchi ,
Hiroshi Nonogi  and
Shigeyuki Echigo
Etsuko Tsuda
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Osaka, Japan
Mai Matsuo
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Osaka, Japan
Hiroaki Naito
Affiliation:
Department of Radiology,* National Cardiovascular Center, Osaka, Japan
Teruo Noguchi
Affiliation:
Department of Cardiovascular Medicine, National Cardiovascular Center, Osaka, Japan
Hiroshi Nonogi
Affiliation:
Department of Cardiovascular Medicine, National Cardiovascular Center, Osaka, Japan
Shigeyuki Echigo
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Osaka, Japan
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Abstract

There exists a population of adults with undiagnosed coronary arterial lesions due to Kawasaki disease occurring before 1967. We report the clinical features in 6 adult males with coronary arterial lesions caused by presumed Kawasaki disease, whose dates of birth ranged from 1945 to 1963. The age of the diagnosed coronary arterial lesions due to presumed Kawasaki disease ranged from 26 to 48 years. In 4 patients, there was a history of probable Kawasaki disease. The presenting features were chest pain in 2; syncope in 1, an abnormal electrocardiogram in 2; a history of presumed Kawasaki disease in 1, and symptomatic myocardial infarction in the final patient. Coronary angiograms revealed multi-vessel disease in 5 patients, with segmental stenosis in 5, and calcified giant aneurysms in the proximal portion of the coronary arteries also in 5. Low left ventricular ejection fractions of less than 40% were found in 3. Of the patients, 3 had undergone coronary arterial bypass grafting. A defibrillator had been implanted in 2 because of rapid ventricular tachycardia with syncope induced during electrophysiologic studies. We conclude that, in patients with multi-vessel disease or left ventricular dysfunction caused by presumed Kawasaki disease, symptoms and serious cardiac events occur in adult life with the onset of ageing, although the patients had been asymptomatic for many years after the onset of Kawasaki disease itself.

Keywords

Coronary aneurysmcoronary arterial calcificarionatherosclerosisacute myocardial infarctionventricular tachycardiamucocutaneous lymph node syndrome
Type
Original Article
Information
Cardiology in the Young , Volume 17 , Issue 1 , February 2007 , pp. 84 - 89
Copyright
2007 Cambridge University Press

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