Key result
Echocardiography detects early coronary ectasia and microaneurysms on day 5 of Kawasaki disease.
Why the study?
Coronary artery aneurysms in Kawasaki disease typically develop after several weeks, raising the question of whether they can also present as an early manifestation.
Case Report (n=1)
No
This case demonstrates that coronary artery microaneurysms can manifest as early as day 5 of fever in Kawasaki disease rather than solely as a late sequela, supporting early echocardiographic screening in suspected patients.
Answers are grounded in this paper and cite their sources.
Early coronary involvement may occur by day 5 in Kawasaki disease; this case report leaves open optimal echocardiography timing.
Introduction: Kawasaki disease (KD) is a medium-vessel vasculitis with a predilection for coronary arteries and has been recognized to be the most common cause of acquired heart disease in children (Hedrich et al., 2018; Newburger et al., 2016; Saguil et al., 2015; Singh et al., 2018; Sundel, 2015). Hedrich et al. (2018) outline how coronary artery aneurysms are a typical manifestation of KD that develops after several weeks of disease. Case presentation: This case report describes the clinical course and outcomes of a patient, a 5-year-old Hispanic female with KD who displayed early development of coronary microaneurysms as opposed to the typical late sequelae development. Discussion and conclusion: This unique presentation of KD highlights some crucial questions that should be addressed, including whether coronary artery aneurysms should be reconsidered as only a late sequela of untreated disease. Can coronary artery aneurysms be an early manifestation of KD?
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Shea‐Lee Godin (2023) conducted a case report in Kawasaki disease (n=1). Echocardiogram, high-dose aspirin, and intravenous immunoglobulin (IVIG) was evaluated on Development of coronary artery microaneurysms on echocardiogram. Echocardiography on day 5 of persistent fever revealed diffuse left coronary artery ectasia and proximal left anterior descending microaneurysms (0.3x0.3x0.1 cm and 0.4 cm) in a 5-year-old with Kawasaki disease.
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