Kawasaki Disease with Coronary Artery Bypass Grafting
Background: Chest pain is uncommon in the pediatric age group, with Kawasaki disease being a rare cause characterized by a generalized vasculitis framework, which mainly affects vessels of medium caliber. Kawasaki disease has universal occurrence and affects all pediatric groups, and 85% of cases are in patients up to 5 years of age. It has a higher incidence in boys, around 1.5:1 in relation to girls. The main complication is cardiac lesions by the involvement of the coronary arteries, corresponding to 20% of cases. In this article, we report a case of Kawasaki disease that evolved with the need to coronary artery bypass grafting. Case presentation: A 5-year-old female patient, referring abrupt onset of fever, polymorphous rash, arthralgia, and rash desquamation on hands and feet in 2002, was diagnosed with Kawasaki disease and treated with acetylsalicylic acid. At age 17, the patient had chest pain in distress, severe dyspnea, sweating, nausea, and vomiting. In the hemodynamic study, the patient presented cardiac abnormalities that needed to be corrected with coronary artery bypass grafting. Conclusion: This case report shows the importance of early diagnosis and treatment of Kawasaki disease in order to avoid future complications. In the case reported, the patient required surgical intervention years after presenting the acute condition.
- 2.Metze K. Blood and lymphatic vessels. In: Filho GB, editor. Bogliolo: pathology. Rio de Janeiro: Guanabara Koogan; 2011. p. 507.Google Scholar
- 3.Mitchel RN, Schoen FJ. Blood vessels. In: Kumar V, Abbas AK, Fausto N, Aster JC, editors. Robbins & Cotran: Patologia – pathological basis of disease. Rio de Janeiro: Elsevier; 2010. p. 523.Google Scholar
- 4.Pfeiffer MET. Chest pain in children and adolescents: why, when and how to evaluate the heart? Revista do DERC. 2012;18(3):86–90.Google Scholar