What are the cardiovascular complications of Kawasaki disease?

Updated: Jul 29, 2018
  • Author: Tina K Sosa, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

The prognosis relies on the extent and severity of cardiac disease. KD has surpassed rheumatic heart disease as the leading cause of acquired heart disease in the United States in children under the age of 5 years. Cardiovascular complications include the following:

  • Diffuse coronary artery ectasia and aneurysm formation, including giant aneurysms
  • Clinically significant heart failure or myocardial dysfunction (unlikely to occur once fever is resolved)

  • Myocardial infarction

  • Myocarditis (common, but rarely causes chronic heart failure)

  • Valvulitis, usually mitral (only occurs in 1% of patients and rarely requires valve replacement)

  • Pericarditis with small pericardial effusions (occurs in 25% of patients with acute illness)

  • Systemic arterial aneurysms

  • Rupture of coronary artery aneurysms with hemopericardium

Approximately 20-25% of untreated patients develop cardiac sequelae, including CAAs. Aneurysms develop in 3-5% of patients treated with IVIG before the 10th day of illness. [49]


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