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Kawasaki disease complications

Patients with Kawasaki disease can develop heart complications such as mild dilatation of the coronary arteries. These abnormalities, usually diagnosed in the first two weeks of the illness, are likely to resolve spontaneously within a few weeks or months.

However, some patients may suffer from more serious complications such as coronary aneurysm, which can result in further heart problems.

“About 30 per cent of patients develop coronary abnormalities and about 5 per cent develop coronary aneurysm, which is a more significant and long-term problem,” says Associate Professor Tan Teng Hong, Head and Senior Consultant, Cardiology Service, KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group.

“Coronary aneurysm can lead to coronary insufficiency due to blockage, decreased cardiac function (weak heart), abnormal heart rhythms or sudden death,” he added.

Other potential heart complications, though less common, include acute myocarditis (inflammation of the heart muscle), valve leakage, pericardial effusion, arrhythmias (abnormal heart rhythms) and acute myocardial infarction.

“Children who are younger, who show atypical presentation of Kawasaki disease, who are resistant to intravenous immunoglobulins, or those who have had recurrent Kawasaki disease, will have a higher risk of developing heart problems,” says A/Prof Tan.

Treatment for Kawasaki disease

Kawasaki disease treatment generally entails hospitalisation for 3-7 days. The mainstay of treatment of Kawasaki disease is intravenous immunoglobulin (IVIG), to help reduce the risk of heart problems.

Aspirin is also used as an adjunct treatment -- high doses of aspirin are given in the acute phase, and converted to low, once-a-day doses later in the subacute phase of the disease.

After Kawasaki disease treatment, the patient will require follow-up heart ultrasound scans (echocardiograms) to ensure there are no complications from the disease.

Ref: R14