3: Cardio - Kawasaki Disease Flashcards
What is Kawasaki disease referred to as
Mucocutaneous Lymph Node Syndrome
What is Kawasaki disease
Febrile vasculitis - predominantly affecting coronary and medium size vessels
Which age-group does Kawasaki disease occur
Under 5’s
What gender is Kawasaki disease more common in
Males
What ethnicity does Kawasaki disease occur in
Asians
Afro-carribeans
What is the most common cause of acquired heart disease in developed countries
Kawasaki Disease
What is the most common cause of acquired heart disease in developing countries
Rheumatic Fever
What is a mnemonic to remember symptoms of Kawasaki disease
CRASH and burn
Conjunctivitis Rash lymphAdenopathy Strawberry tongue Hand + feet - red
Burn: Fever >5d
What is the criteria for Kawasaki disease
Need 5-out-of-6 of the following:
- Fever >5d
- Oropharyngeal mucositis
- Lymphadenopathy
- Polymorphous Rash
- Bilateral, Non-purulent conjunctivitis
- Red hand + feet - lead to desquamatisation
How long should the fever last in Kawasaki disease
5d
What are three symptoms/signs of oropharyngeal mucositis
- Red pharynx
- Strawberry tongue
- cracked red lips
What type of conjunctivitis is present in Kawasaki disease
Bilateral, non-purulent conjunctivitis
What type of rash is present in Kawasaki disease
Polymorphous rash - which originates on the trunk
Where does the rash in Kawasaki disease originate
The trunk
What is the mneumonic to remember symptoms of Kawasaki disease
CRASH and BURN
What are three non-specific features of Kawasaki disease that may precede classical symptoms
Abdominal pain
Diarrhoea
Faitgue
When should Kawasaki disease always be considered
If child has rash and high temperature that is not responding to Abx
Explain pathophysiology of Kawasaki disease
- Autoimmune damage to vessels exposes TF on the endothelium of medium-size and coronary arteries
- This triggers the coagulation cascade leading to thrombosis
- Of coronary vessels this can cause MI
- Damage to artery walls causes weakening that can lead to aneurysms - may rupture
- Damage and healing by fibrosis also results in stenosis
How is Kawasaki disease diagnosed
Clinical diagnosis, supported by investigations
What investigations may be ordered in Kawasaki disease
- ESR/CRP
- FBC
- Anti-endothelial cell antibodies
- ECHO
How will ESR and CRP present in Kawasaki disease
Raised
How will FBC present in Kawasaki disease
Leucocytosis
Thrombocytosis
Why is an ECHO required in Kawasaki disease
Evaluate for coronary aneurysms
What is given to manage Kawasaki disease
- IVIG
- High-dose Oral aspirin
- IV Glucocorticoids
When should IVIG be given in Kawasaki disease
Within 10d
What is the advantage of giving IVIG within 10d in Kawasaki disease
Reduces risk of coronary artery aneurysms
What is the only exception to give aspirin to children under 16
Kawasaki disease
Why is aspirin not normally given to children under 16y
Risk of Reye’s syndrome
When is IV Glucocorticoids given in Kawasaki disease
High risk patients or refractory disease
How long does Kawasaki disease take to resolve
6-8W
What is the main risk of Kawasaki disease
Coronary artery aneurysms - more common 2-3W in
What are 3 other cardiac risks of Kawasaki disease
MI
Arrythmias
Myocarditis
