State-of-the-Art Paper
When Children With Kawasaki Disease Grow Up: Myocardial and Vascular Complications in Adulthood

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Kawasaki disease (KD) is an acute, self-limited vasculitis that typically occurs in young children and was first described by Japanese pediatrician Tomisaku Kawasaki in 1967. Although originally thought to be a rare condition, KD has become the most common cause of acquired heart disease in the pediatric age group in developed countries. The majority of patients with KD appear to have a benign prognosis, but a subset of patients with coronary artery aneurysms are at risk for ischemic events and require lifelong treatment. In the 4 decades that have passed since the initial recognition of KD, the number of patients reaching adulthood has continued to grow. Adult cardiologists will be increasingly involved in the management of these patients. Currently, there are no established guidelines for the evaluation and treatment of adult patients who have had KD. We review here the current literature that may be helpful to clinicians who care for adults who experienced KD in childhood.

Key Words

aneurysm
vasculitis
myocardial infarction
myocardial flow reserve
myocarditis

Abbreviations and Acronyms

AHA
American Heart Association
CT
computed tomography
IMT
intimal medial thickness
IVIG
intravenous immunoglobulin
KD
Kawasaki disease
LOE
Level of Evidence
MR
magnetic resonance
SMR
standardized mortality ratio

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This work supported in part by a grant from the National Institutes of Health, Heart, Lung, Blood Instituteto Dr. Burns (RO1-HL69413). Masato Takahashi, MD, served as Guest Editor for this article.