Risk of acute coronary syndromes with prior Kawasaki disease

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Kawasaki disease is a rare condition that mainly affects children under the age of five, with around eight in every 100,000 children developing it in the UK each year.

But did you know that around 10-20% of all children with Kawasaki disease also develop aneurysms, and are at long-term risk of thrombosis and/or stenosis of the coronary artery?

More patients affected by the disease in early childhood are now entering adult life, and are at lifelong risk of acute coronary syndromes.

NHS Improvement has released an alert across the healthcare sector on the issue after two reported cases where the likelihood of coronary thrombosis wasn’t recognised, and as a result caused a delay in diagnosis. It’s thought this may have increased the risk of death or severe harm to those patients.

Please be aware of the cardiovascular risks associated with prior Kawasaki disease; these patients are high risk and may have atypical presentation of coronary artery aneurysms, coronary thrombosis, and myocardial ischaemia or infarction. Prompt diagnosis and urgent investigation and treatment is required for symptoms of chest pain, pallor, excessive tiredness or breathlessness.

Kawasaki disease itself is usually treated in hospital as it can sometimes lead to serious complications. The characteristic symptoms are a high temperature that lasts for more than five days, with: a rash; swollen glands in the neck; dry, cracked lips; red fingers or toes; and red eyes. After a few weeks the symptoms become less severe, but may last longer, and at this stage the affected child may have peeling skin on their fingers and toes.

Intravenous immunoglobulin (IVIG), a solution of antibodies, and aspirin are the two main medicines used to treat Kawasaki disease.

Want to know more? Download a copy of the alert from the NHS Improvement website, or visit NHS Choices for more information on Kawasaki disease itself.

Published 2nd June, 2016

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