Coronary Artery Aneurysms and Thrombosis in Kawasaki Disease

Kawasaki disease (KD) is an acute vasculitis of unknown etiology occurring in infants and young children and affecting medium-sized muscular arteries. It is a systemic disease, with possibly morbid to mortal manifestations in the cardiovascular system, including lymphocytic myocarditis and acute vasculitis associated with thrombosis and/or aneurysm formation. In regards to aneurysm formation, coronary artery involvement occurs in up to 40% of patients and can range from transient, mild dilatation or ectasia to giant coronary artery aneurysm. Treatment with aspirin and intravenous immunoglobulin (IVIG) therapy greatly reduces the occurrence of coronary artery aneurysm. Patients with large or giant coronary artery aneurysms are especially at risk for cardiac events including coronary artery thrombosis or stenosis, myocardial infarction, arrhythmias, and death (1)