Vijayvergiya Rajesh, Bhattad Sagar, Varma Subhash, Singhal Manphool, Gordon John, Singh Surjit
Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Pediatric Allergy and Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Int J Rheum Dis. 2017 Aug;20(8):1023-1027. doi: 10.1111/1756-185X.13073. Epub 2017 Apr 5.
Kawasaki disease (KD) is the most common cause of acquired heart disease in children in Japan, North America and Europe. Undiagnosed and untreated KD can have clinically significant consequences later in life. The clinical spectrum of missed childhood KD is frequently being recognized during adulthood. We report four adult cases of acute coronary events, in which coronary angiography was suggestive of sequelae of KD.
Four adults who presented with acute coronary events, had coronary angiography for evaluation. Indoor-admission files were analyzed for the clinical details of individual cases.
Two cases were below 40 years of age. None of the patients had any known conventional risk factors for atherosclerosis. Case 4 had a clinical history of childhood KD. Coronary angiography revealed ectasia of multiple coronary arteries and stenosis in distal segments in the first three cases and large thrombosed aneurysm with calcified walls in the fourth case.
We hereby report four adult cases with acute coronary events, who had markedly dilated coronary artery segments suggestive of possible sequelae of childhood KD.
川崎病（KD）是日本、北美和欧洲儿童后天性心脏病的最常见病因。未诊断和未治疗的KD在日后生活中可能产生具有临床意义的后果。儿童期漏诊的KD临床谱在成年期经常被发现。我们报告4例成人急性冠状动脉事件，其中冠状动脉造影提示为KD后遗症。
4例出现急性冠状动脉事件的成人接受冠状动脉造影以进行评估。分析住院病历以获取各病例的临床细节。
2例年龄低于40岁。所有患者均无已知的传统动脉粥样硬化危险因素。病例4有儿童期KD病史。冠状动脉造影显示，前三例有多支冠状动脉扩张及远端节段狭窄，第四例有大的血栓形成性动脉瘤且瘤壁钙化。
我们在此报告4例成人急性冠状动脉事件，其冠状动脉节段明显扩张，提示可能为儿童期KD的后遗症。
