A Case Of Kawasaki Disease

Kawasaki disease, also known as mucocutaneous lymph node syndrome (MCLS), is a multi-systemic vasculitis of unknown etiology that predominantly involves the coronary arteries, causing various cardiac sequelae that, if left untreated, may be fatal and life-threatening. The disease mainly affects infants and young children, especially those in Asian countries, and rarely teenagers and adults. Incomplete or atypical Kawasaki disease is reported in up to36%of all Kawasaki disease cases and commonly affects children younger than6months old. The incomplete presentations are usually linked to higher incidence of coronary artery aneurysms formation than the complete presentations. Initial diagnosis of Kawasaki disease is made primarily based on the clinical presentations of the patients and can be very difficult to establish because the symptoms tend to present at different times. Careful and detailed medical history and repeated observations and examinations are crucial to establish the diagnosis. Coronary artery aneurysm is the most common yet the most life-threatening cardiac complication that develops in approximately25%of untreated Kawasaki disease patients. Advances have been made in the treatment of the disease with introduction of aspirin and IVIG therapy as the initial regimen that show significant reduction of coronary artery aneurysms formation and mortality rate. We report a case of Kawasaki disease in a14-year-old Asian girl who presented with sudden cardiopulmonary arrest during exercise. Giant coronary artery aneurysm was visible on echocardiogram, coronary CTA and coronary angiogram. CABG was performed successfully and she was discharged on combined antiplatelet therapy.