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.