Heart and Vessels

, Volume 5, Issue 1, pp 47–51 | Cite as

Long-term prognosis of Kawasaki disease patients with coronary artery obstruction

  • Katsunori Tatara
  • Sanji Kusakawa
  • Keiko Itoh
  • Norio Kazuma
  • Keiei Lee
  • Keiko Hashimoto
  • Tokuko Shinohara
  • Chisato Kondoh
  • Michiaki Hiroe
Originals

Summary

The prognosis of coronary artery obstruction was studied in patients with Kawasaki disease. Between May 1973 and December 1987, coronary artery obstruction was diagnosed by coronary angiography in 30 patients (21 males, 9 females), of whom, only 8 (26.7%) had clinical symptoms. One patient died after 9 years of illness. Two complained of frequent chest pain, which disappeared after bypass surgery in one case and spontaneously in the other. Five had symptomatic myocardial infarction. Myocardial ischemia was diagnosed in 31.8% by treadmill stress testing, but was well demonstrated in 85.7% by thallium-201 myocardial tomography. Frequent ventricular premature beats, Wenckebachtype atrioventricular block, and ST-segment depression accompanied by chest pain were recognized by 24-h Holter monitoring. In the past, the methods used to determine the prognosis of Kawasaki disease patients with coronary artery obstruction were not adequate. However, the examinations used in this study revealed an improved ability to determine the prognosis in this disease. Myocardial tomography, in particular, provided a more accurate evaluation of myocardial damage. Ventricular arrhythmias seem to be a serious problem in these patients. Therefore, careful observation using these tests, especially myocardial tomography and Holter monitoring, should be done even if the patients are free of symptoms.

Key words

Kawasaki disease Coronary artery obstruction Treadmill stress test Thallium-201 myocardial tomography Long-term prognosis 

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Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • Katsunori Tatara
    • 1
  • Sanji Kusakawa
    • 1
  • Keiko Itoh
    • 1
  • Norio Kazuma
    • 1
  • Keiei Lee
    • 1
  • Keiko Hashimoto
    • 1
  • Tokuko Shinohara
    • 1
  • Chisato Kondoh
    • 2
  • Michiaki Hiroe
    • 2
  1. 1.Department of PediatricsTokyo Women's Medical College Daini HospitalTokyoJapan
  2. 2.Department of RadiologyTokyo Women's Medical CollegeTokyoJapan

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