KD & The Heart

Kawasaki Disease and the Heart

Kawasaki disease (KD) primarily affects the blood vessels and can cause significant damage to the heart, particularly when not diagnosed and treated early. The disease causes inflammation of the arteries, including the coronary arteries, which supply blood to the heart muscle. This inflammation can lead to several serious cardiac complications if not properly managed.

How Kawasaki Disease Affects the Heart

1. Inflammation of the Coronary Arteries:
   • Coronary artery aneurysms: One of the most serious complications of Kawasaki disease is the formation of aneurysms in the coronary arteries. An aneurysm is a bulge in the artery wall, which can weaken the vessel and increase the risk of it bursting or causing a clot. These aneurysms can block blood flow to the heart, leading to myocardial infarction (heart attack) or heart failure.
   • The coronary arteries are at the greatest risk of damage during the acute phase of the disease. The inflammation can cause narrowing or dilation, which affects the blood supply to the heart muscle.
2. Myocardial Infarction (Heart Attack):
   • If the coronary arteries are significantly damaged or blocked by aneurysms or thrombosis (blood clots), it can reduce the heart’s blood supply. This can lead to myocardial infarction (heart attack), even in children, which is relatively rare but possible in severe cases of KD.
3. Heart Valve Problems:
   • Kawasaki disease can also cause inflammation in the heart valves, particularly the mitral or aortic valves. This may lead to valvular insufficiency, where the valves do not close properly, potentially resulting in heart murmurs or more severe issues like heart failure.
4. Arrhythmias:
   • The inflammation of the heart and its arteries can disrupt the heart’s electrical system, leading to arrhythmias (irregular heartbeats). These arrhythmias can range from mild to life-threatening conditions, requiring ongoing monitoring and management.
5. Cardiomyopathy:
   • In severe cases, Kawasaki disease can lead to dilated cardiomyopathy, a condition where the heart becomes enlarged and weakened, impairing its ability to pump blood effectively.
6. Pericarditis:
   • Kawasaki disease can also cause inflammation of the pericardium, the sac that surrounds the heart, known as pericarditis. This can lead to chest pain and affect the heart’s ability to function properly.

Impact on the Long-term Heart Health of Children with Kawasaki Disease

Even after the acute phase of Kawasaki disease is treated, the damage to the coronary arteries and other heart structures can have long-term effects. Children with heart complications from Kawasaki disease are at increased risk for:

• Aneurysms in the coronary arteries, requiring lifelong follow-up.
• Atherosclerosis (plaque buildup in the arteries) that may develop later in life, putting them at risk for heart disease.
• Heart failure or other long-term cardiac complications if the coronary damage is extensive.

Treatment to Prevent Heart Damage

Early treatment with intravenous immunoglobulin (IVIG) is critical for reducing the risk of heart complications. IVIG helps to reduce inflammation, which can prevent the formation of coronary artery aneurysms and minimize the long-term heart damage caused by Kawasaki disease. Additionally, aspirin is often prescribed to help prevent blood clotting and reduce inflammation.

When dealing with resistant cases of Kawasaki disease, infliximab emerges as a promising alternative treatment. Research indicates that children receiving infliximab are significantly more likely to have their fever diminish within just 24 hours compared to those who undergo a second dose of IVIG. This remarkable treatment not only leads to shorter fever durations but also results in reduced hospital stays, offering a more efficient path to recovery. Discover more about how infliximab can transform the management of Kawasaki disease in resistant cases here: https://kdfoundation.org/treating-resistant-kawasaki-disease/.

Resources for More Information on Kawasaki Disease and Its Effects on the Heart

1. American Heart Association (AHA):
   • The AHA provides comprehensive information about Kawasaki disease, especially its impact on heart health, including prevention and long-term management.
   • Website: American Heart Association – Kawasaki Disease
2. Centers for Disease Control and Prevention (CDC):
   • The CDC provides essential facts about Kawasaki disease, including the risk to heart health and guidelines for treatment.
   • Website: CDC – Kawasaki Disease
3. Mayo Clinic:
   • Mayo Clinic’s website offers an in-depth explanation of Kawasaki disease, including its cardiac implications and the importance of early treatment.
   • Website: Mayo Clinic – Kawasaki Disease

Conclusion

Kawasaki disease can have a significant impact on the heart, particularly in the form of coronary artery aneurysms and other cardiovascular complications. Early diagnosis and treatment, including IVIG therapy, are crucial in preventing long-term heart damage. Regular follow-up care and heart monitoring are essential for children who have had Kawasaki disease to ensure that any complications are identified and treated early.

For a deeper understanding of how Kawasaki disease impacts the coronary arteries, be sure to check out the enlightening video below. It provides valuable insights that are essential for grasping this important health issue.