Key result
CTA detects asymptomatic RCA obstruction in a teenager with prior Kawasaki disease.
Why the study?
Kawasaki disease can cause coronary artery aneurysms that may progress to stenosis or obstruction, requiring careful follow-up with imaging beyond echocardiography.
Case Report (n=1)
This case highlights the necessity of using advanced imaging modalities like CT or MR angiography for long-term follow-up of Kawasaki disease patients, as echocardiography alone may miss asymptomatic coronary obstruction.
May support advanced imaging for asymptomatic Kawasaki surveillance; leaves open optimal protocols and outcome impact.
Kawasaki disease (KD) is a febrile vasculitis and is considered a leading cause of acquired coronary artery disease in children. A clinically critical complication is the coronary artery aneurysm, which may progress and lead to coronary stenosis or even obstruction. Herein, we describe a 14.5-year-old boy with a history of KD at 6 months old, who developed multiple aneurysms along all the coronary branches. During the follow-up at the age of 14 years, the left coronary artery aneurysms regressed, while the aneurysm of the right coronary artery persisted and was complicated by obstruction at its proximal part, according to computed tomography angiography. However, the patient at the last follow-up was asymptomatic and well. The serious nature of KD coronary complications warrants follow-up visits. Since echocardiography alone may fail to reveal stenosis or obstruction, other adjunct follow-up imaging modalities such as conventional, computed tomography, and magnetic resonance angiography should be performed in patients with coronary aneurysms.
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Sabri et al. (2022) conducted a case report in Kawasaki disease with coronary obstruction (n=1). Computed tomography angiography was evaluated on Coronary artery status. A 14.5-year-old boy with a history of Kawasaki disease developed right coronary artery obstruction despite being asymptomatic, highlighting the need for advanced imaging like CT angiography.
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