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A rare case of Kawasaki Disease with Giant coronary artery aneurysm
Prateek Vaswani, Sr., Yatin Arora, Manoj K. Sahu, Velayoudam Devagourou
All India Institute of Medical Sciences, New Delhi, New Delhi, India

Background: Kawasaki disease (KD) is an acute, self-limiting vasculitis that occurs in children of all ages. This was first described by Kawasaki in 1967. Spontaneous regression is observed, however, 25% of patients develop coronary artery aneurysm (CAA). These may result in ischemic heart disease causing myocardial infarction, rupture leading to pericardial tamponade and distal embolization which culminate in sudden cardiac death. Diagnosis of KD relies on clinical suspicion with no gold standard diagnostic test. Method: A case of KD with giant CAA in a 14 year old female is described with emphasis on challenges pre and peri-operatively. The PubMed database was searched for "Kawasaki disease" and "Coronary artery aneurysm", subsequently literature review was done in accordance with the relevance with our case.RESULTS: The review provided post case description emphasizes on pathophysiology with clinical course of CAA in association with KD and justification of our approach with an insight into newer treatment modalities. The CT reconstructed images have been provided for understanding.
Conclusion:CAA should be kept in mind as differential for angina in paediatric population. Coronary artery bypass grafting using arterial conduits should be the preferred treatment strategy for CAA. The follow up needs to be individualized with multi-disciplinary team for both cardiac and other systemic complications.


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