KAWASAKI SYNDROME WITH INVOLVEMENT OF CARDIOVASCULAR SYSTEM: LONG-TERM CONSEQUENCES

Abstract

Kawasaki syndrome is an acute systemic vasculitis with unknown etiology, affecting primary children at the age of 0–5 years old, which can be of a real threat for health and life not only during acute stage of the disease, but also many years after. The main prognostic factor is involvement of the coronary arteries with aneurisms development and high risk of consequent thrombosis and/or stenosis of the coronary arteries, which can lead to myocardial ischemia/infarction and sudden death syndrome in young patients. Different variants of long-term pathological changes of the coronary arteries are discussed in the article. Aneurisms regressed in 50–60% of involved segments of the coronary arteries within first 2 years after active stage. The probability of regression of aneurisms depends on their diameter, form, localization and patient’s age. Gigantic sizes of aneurisms have the highest risk of coronary thrombosis and stenosis. Clinical consequences of coronary thrombosis vary from asymptomatic course to myocardial infarction, depending on thrombus size and localization. The risk of coronary stenosis depends on aneurism size and increases with time passed from the onset of the disease. The authors give information on diagnostic possibilities of instrumental methods of investigation of the coronary arteries, management of follow-up and treatment of reconvalescents in order to decrease risk of life-threatening conditions. The shown data are based on the literature review and own experience of observation of 90 patients with Kawasaki syndrome with the onset of the disease between 2004 and 2010 years.