Introduction
Kawasaki disease (KD) is
a systemic
vasculitis involving all blood vessels, but principally medium-sized
arteries and is a common vasculitis in childhood (1). It can lead to
severe adverse events, morbidity and mortality if not suitably managed.
Majority of patients have less than five years old and male to female
ratio is about 1.3-1.6:1 (2, 3). It is a widespread disorder all over
the world with higher predispose in Asian ethnic.
Typically, KD can be diagnosed by fever
persisting for at least 5 days, and the presence of at least four of the
following principal features: (1) changes in the extremities; (2)
polymorphous exanthema; (3) bilateral
bulbar conjunctival
injection without exudates; (4) changes in the lips
and oral
cavity; and (5)
cervical lymphadenopathy (>1.5 cm
diameter). Exclusion of other diseases with similar symptoms is also
necessary (4). When involving the cardiovascular system, patients may
present
with myocarditis, pericarditis, coronary
artery aneurysm,
and aortic
root dilatation (2).
Because of the systemic involvement, it has high variability in all
organ systems, and early diagnosis in patients with atypical KD or in
those with uncommon manifestations is difficult. With the wide-spread
use
of computed
tomography (CT), there is an increasing number of reports of KD with
retropharyngeal edema and
enlarged cervical
adenopathy (5, 6). Progressing into shock is uncommon, although some
studies have reported patients with KD
and shock
syndrome (7, 8). In this report in addition to interesting
echocardiographic and angiographic films and views, diagnostic criteria,
cardiovascular involvement, risk factors also have been reviewed in KD
patients.