Cardiovascular: Kawasaki Disease Flashcards
What is Kawasaki disease?
A type of systemic vasculitis predominantly seen in children
While it is uncommon, it is important to recognise early because…
Can cause serious complications - coronary artery aneurysms
What age group does it typically affect?
6 months to 4 years
Peak = end of first year
What causes it?
Unknown
What features are associated?
High grade fever lasting > 5 days and characteristically resistant to antipyretics
Conjunctival injection
Bright red, cracked lips
Cervical lymphadenopathy
Strawberry tongue
Red palms of hands and soles, which later peel
May have inflammation of BCG vaccination scar
How is it diagnosed?
Clinically
There is no diagnostic test
What do bloods typically show?
High inflammatory markers - CRP, ESR, WCC, platelets rise in second week of illness
The coronary arteries are affected in what fraction?
1/3 within first 6 weeks
How can the aneurysms be detected?
ECHO
How is it managed?
IV immunoglobulin within first 10 days - lower coronary artery aneurysm risk
Aspirin to reduce thrombosis risk - high dose until fever subsides and inflammatory markers return to normal
If there is persistent inflammation and fever, what can be given?
Corticosteroids
Infliximab or cyclosporin
Other than coronary artery aneurysm, what other cardiac features can occur?
Pericardial effusion
Myocardial disease - poor contractility
Endocarditis disease - valve regurgitation
