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Joseph Junewick, MD FACR
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Kawasaki Disease

Case Detail

Anatomy: Chest
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Vascular
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: CT
Activities:
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History

14 year old female with history of Kawasaki disease.


Case Images


Diagnosis

Coronary Artery Aneurysm – Kawasaki Disease

Findings

CT – Curved reformatted image from CT coronary arteriogram demonstrates multiple saccular aneurysms of the right coronary artery.

Discussion

Coronary artery aneurysms are defined as coronary artery segments that have a diameter of 1.5 times that of adjacent normal segments and involve less than 50% of the length of the vessel. Etiologies include atherosclerotic vascular disease (50%), congenital (17%), and infectious (10%).

Kawasaki disease (mucocutaneous lymph node syndrome) is an acute self-limited panarteritis. The etiology is unclear but likely related to infection and/or autoimmune dysfunction. Symptoms important in the diagnosis include fever, polymorphic rash, conjuctivitis, cervical adenitis, desquamation of the hands and feet, and inflammation of the lips and oral cavity. Males are more commonly affected and most patients are less than 5 years of age.

Coronary artery sequelae are common with Kawasaki disease. Coronary artery aneurysms develop in 15-25% of cases; coronary artery aneurysm is less common if patients are treated with gamma globulin. Coronary artery aneurysm spontaneously resolve in nearly half. Other short/long-term coronary artery complications include premature atherosclerosis, stenosis, thrombosis and occlusion. Coronary CT angiography provides a safe noninvasive approach to accurately diagnose coronary artery aneurysms.
Other cardiac complications include myocarditis and valvular disease.

Reference

Diaz-Zamudio M et al. Coronary artery aneurysm and ectasia: Role of coronary artery CT angiography. Radiographics (2009); 29:1939-1954.

Kruskal, J B; Hartnell, G G. Nonatherosclerotic coronary artery disease: more than just stenosis. Radiographics March 1995 15:383-396.

Contributor

Saima Ghori, MD



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