Skip to main content Accessibility help
×
Home

Changes in causes of sudden deaths by decade in patients with coronary arterial lesions due to Kawasaki disease

  • Etsuko Tsuda (a1), Yoshio Arakaki (a2), Toshio Shimizu (a1), Heima Sakaguchi (a1), Shinichiro Yoshimura (a1), Satoshi Yazaki (a1) and Shigeyuki Echigo (a1)...

Abstract

Over a 25-year period, we encountered 12 patients who died suddenly with coronary arterial lesions due to Kawasaki disease. We report their clinical course, and analyze the happenings of their deaths. Of the 12 patients, 10 were dead on arrival at hospital. Their age at death ranged from 13 months to 27 years, with a median of 16 years, and the interval from the onset of Kawasaki disease to death ranged from 2 months to 24 years. In 4 patients, death was found to be due to myocardial infarction, while in the remaining 8, it could not be determined. In 7 patients, coronary angiograms obtained less than 4 months after the acute onset of Kawasaki disease showed lesions bilaterally, most being giant aneurysms. Myocardial infarction had occurred in 6 patients prior to their death. In 1 patient of the late 1970s, who collapsed after running, cardiac sequels had not been suspected prior to autopsy. During the 1980s, 3 infants with bilateral giant aneurysms died within a year of the initial onset of Kawasaki disease, with acute myocardial infarction being the cause in 2 of them. In the late 1990s, and the 2000s, 5 patients died suddenly with left ventricular dysfunction, their ejection fractions being less than 40 percent more than 20 years after the initial onset of Kawasaki disease. Prior to their sudden deaths, they had had no cardiac events for many years, but had suffered previous myocardial infarctions. Multifocal premature ventricular contractions, and non-sustained ventricular tachycardia, are probable risk factors in such patients. Careful follow-up, checking for ventricular arrhythmia, is needed to prevent sudden death in patients suffering left ventricular dysfunction in the setting of Kawasaki disease.

Copyright

Corresponding author

Correspondence to: Etsuko Tsuda MD, Department of Pediatrics, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita-shi, Osaka, 565-8565, Japan. Tel: +81 66 833 5012; Fax: +81 66 872 7486; E-mail: etsuda@hsp.ncvc.go.jp

References

Hide All

References

Kawasaki T, Kosaka F, Ozawa S, Shigematsu I, Yanagawa H. A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics 1974; 54: 271276.
Kato H, Sugimura T, Akagi T, et al. Long-term consequences of Kawasaki disease. A 10 to 21 year follow-up study of 594 patients. Circulation 1996; 94: 13791385.
Nakamura Y, Yanagawa H, Harada K, Kato H, Kawasaki T. Mortality among patients with a history of Kawasaki disease: the third look. Acta Paediatr Jpn 2002; 156: 162165.
Kato H, Ichinose E, Kawasaki T. Myocardial infarction in Kawasaki disease: Clinical analyses in 195 cases. J Pediatr 1986; 108: 923927.
Furusho K, Kamiya T, Nakano H, et al. High-dose intravenous gammaglobulin for Kawasaki disease. Lancet 1984; 2: 10551058.
Newburger JW, Takahashi M, Burns JC, et al. The treatment of Kawasaki syndrome with intravenous gamma globulin. N Engl J Med 1986; 315: 341347.
Quam JP, Edwards WD, Bambara JF, Luzier TL. Sudden death in an adolescent four years after recovery from mucocutaneous lymph node syndrome (Kawasaki Disease). JFSCA 1986; 31: 11351141.
Wreford FS, Conradi SE, Cohle SD, Lie JT, Dana SE, Puri S. Sudden death caused by coronary artery aneurysms: A late complication of Kawasaki disease. JFSCA 1991; 36: 5159.
Smith BA, Grider DJ. Sudden death in a young adult: sequelae of childhood Kawasaki disease. Am J Emerg Med 1993; 11: 381383.
Fineschi V, Reattelli LP, Baroldi G. Coronary artery aneurysms in a young adult: a case of sudden death. A late sequelae of Kawasaki disease? Int J Legal Med 1999; 112: 120123.
Madrid AH, Marin-Huerta E, Serrano MC, Barcia F, Villagra F, Rayo I. Aborted sudden death in the chronic phase of Kawasaki disease. Am Heart J 1991; 121: 15471549.
Lier DV, Jores PG, Cools F, Bossaert LL, Vrints CJ. Successful recovery after ventricular fibrillation in a patient with Kawasaki disease. Resuscitation 2000; 44: 215218.
Burke AP, Frab A, Virmani R, Goodid J, Smialek JE. Sports-related and non-sports-related sudden cardiac death in young adults. Am Heart J 1991; 121: 568575.
Kristensen IB, Kristensen BO. Sudden death caused by thrombosed coronary aneurysm. Two unusual cases of Kawasaki disease. Int J Leg Med 1994; 106: 277280.
Rozin L, Koehler SA, Shakir A, Ladham S, Wecht CH. Kawasaki disease. A review of pathologic features of Stage IV disease and two cases of sudden death among asymptomatic young adults. Am J Forensic Med Pathol 2003; 24: 4550.
Burns JC, Shike H, Gordon JB, Malhotra A, Schoenwetter M, Kawasaki T. Sequelae of Kawasaki disease in adolescents and young adults. JACC 1996; 28: 253257.
Kitamura S. The role of coronary bypass operation on children with Kawasaki disease. Coron Artery Dis 2003; 13: 437447.
Tsuda E, Kitamura S, and the Cooperative Study of Japan. National survey of coronary artery bypass grafting for coronary stenosis caused by Kawasaki disease in Japan. Circulation 2004; 110 (Suppl II); II61II66.
Kazuma N, Tatara K, Murata M. Can heart rate variability predict sudden death? A case of sudden death in a child with severe coronary sequelae of Kawasaki disease. Pediatr Cardiol 2000; 21: 403406.
Celermajer DS, Sholler GF, Howman-Giles R, Celermajer JM. Myocardial infarction in childhood: clinical analysis of 17 cases and medium term follow up of survivors. Br Heart J 1991; 65: 332336.
Roberman W, Weinblatt E, Goldberg JD, Frank CW, Chaudhary BS, Shapiroo S. Ventricular premature complexes and sudden death after myocardial infarction. Circulation 1981; 64: 297305.
Hammill SC, Trusty JM, Wood DJ, et al. Influence of ventricular function and presence or absence of coronary artery disease on results of electrophysiologic testing for asymptomatic nonsustained ventricular tachycardia. Am J Cardiol 1990; 65: 722728.
Kim MH, Bruckman D, Krish MM, Kou WH. Outcome of men with ischemic cardiomyopathy, asymptomatic nonsustained ventricular tachycardia, and negative electrophysiologic studies. Am J Cardiol 2000; 85: 119121.
Moss AJ, Hall WJ, Cannom DS, et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. N Engl J Med 1996; 335: 19331940.
Della Bella P, Riva S, Fassini G, et al. Incidence and significance of pleomorphism in patients with postmyocardial infarction ventricular tachycardia. Acute and long-term outcome of radiofrequency catheter ablation. Eur Heart J 2004; 25: 11271138.
Yagi S, Tsuda E, Shimizu W, et al. Two adults requiring implantable defibrillators because of ventricular tachycardia and left ventricular dysfunction caused by presumed Kawasaki disease. Circ J 2005; 69: 870874.

Keywords

Changes in causes of sudden deaths by decade in patients with coronary arterial lesions due to Kawasaki disease

  • Etsuko Tsuda (a1), Yoshio Arakaki (a2), Toshio Shimizu (a1), Heima Sakaguchi (a1), Shinichiro Yoshimura (a1), Satoshi Yazaki (a1) and Shigeyuki Echigo (a1)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed