scholarly journals Kawasaki Disease and General Anesthesia for Dental Treatment: A Case Report

2021 ◽  
Vol 68 (3) ◽  
pp. 146-153
Author(s):  
Sarah Lee ◽  
David B. Guthrie ◽  
Ralph H. Epstein
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Developed Countries ◽  
University Hospital ◽  
Coronary Artery Thrombosis ◽  
Dental Rehabilitation ◽  
Acquired Heart Disease

Kawasaki disease (KD) is an acute vasculitis of childhood and is the leading cause of acquired heart disease in children in developed countries. Failure to quickly diagnose and treat patients with KD can result in severe cardiac sequelae, especially coronary artery aneurysms (CAAs). Patients with a prior diagnosis of KD who require general anesthesia (GA) may present unique challenges depending on the severity of any cardiovascular sequelae. This case report describes the perioperative management of a 5-year-old male patient previously diagnosed with incomplete KD approximately 1 year before presenting to Stony Brook University Hospital for full mouth dental rehabilitation under GA. Most uniquely, the patient was at high risk for coronary artery thrombosis due to a giant CAA of his right coronary artery and a small CAA of his left anterior descending artery. The discussion also includes the implications of dental treatment under GA for patients with a history of KD.

An update on the epidemiology, length of stay, and cost of Kawasaki disease hospitalisation in the United States

2019 ◽  
Vol 29 (06) ◽  
pp. 828-832 ◽  
Author(s):  
Laxmi V. Ghimire ◽  
Fu-Sheng Chou ◽  
Narayan B. Mahotra ◽  
Sharan P. Sharma
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Length Of Stay ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Developed Countries ◽  
The United States ◽  
Hospital Charge ◽  
Acquired Heart Disease ◽  
The Developed Countries

AbstractBackground:Kawasaki disease is an acute vasculitis of childhood and is the leading cause of acquired heart disease in the developed countries.Methods:Data from hospital discharge records were obtained from the National Kids Inpatient Database for years 2009 and 2012. Hospitalisations by months, hospital regions, timing of admission, insurance types, and ethnicity were analysed. Length of stay and total charges were also analysed.Results:There were 10,486 cases of Kawasaki disease from 12,678,005 children hospitalisation. Kawasaki disease was more common between 0 and 5 years old, in male, and in Asian. The January–March quarter had the highest rate compared to the lowest in the July–September quarter (OR=1.62, p < 0.001). Admissions on the weekend had longer length of stay [4.1 days (95 % CI: 3.97–4.31)] as compared to admissions on a weekday [3.72 days (95 % CI: 3.64–3.80), p < 0.001]. Blacks had the longest length of stay and whites had the shortest [4.33 days (95 % CI: 4.12–4.54 days) versus 3.60 days (95 % CI: 3.48–3.72 days), p < 0.001]. Coronary artery aneurysm was identified in 2.7 % of all patients with Kawasaki disease. Children with coronary artery aneurysm were hospitalised longer and had higher hospital charge. Age, admission during weekend, and the presence of coronary artery aneurysm had significant effect on the length of stay.Conclusions:This report provides the most updated epidemiological information on Kawasaki disease hospitalisation. Age, admissions during weekend, and the presence of coronary artery aneurysm are significant contributors to the length of stay.

scholarly journals Cardiac arrest, chronic total occlusion, and occluded stent in a 16-year-old boy with Kawasaki disease: a case report

2020 ◽  
Author(s):  
Michelle J Connolly ◽  
Sarosh Khan ◽  
Matthew E Li Kam Li Kam Wa ◽  
Matthew E Faircloth ◽  
Brian Clapp
Keyword(s):  
Decision Making ◽  
Cardiac Arrest ◽  
Case Report ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Young Patients ◽  
Developed Countries ◽  
Premature Coronary Artery Disease ◽  
Heart Team ◽  
Total Occlusion

Abstract Background Kawasaki disease is the leading cause of premature coronary artery disease in developed countries. As such, patients may require revascularisation as children. However, there are no randomized data guiding treatment so this must be individualized. This case report describes the decision-making in a young patient requiring revascularization who had already suffered stent occlusion. Case summary Our patient, a 16-year-old boy with Kawasaki disease, presented with cardiac arrest during exercise. Coronary angiography showed that a proximal left anterior descending artery stent implanted at the age of 8 years had occluded some time ago and his right coronary artery was also chronically occluded. He has discussed in several Heart Team meetings and with international colleagues and a consensus reached to revascularize him surgically. Discussion It is vital that young patients with complex coronary disease are discussed in an extensive multidisciplinary setting to determine the most suitable means of treatment. The previously occluded stent was crucial in the individualized decision-making in this patient.

scholarly journals Kawasaki disease with bronchopneumonia: A case report

2012 ◽  
Vol 1 (8) ◽  
pp. 226-228
Author(s):  
Dayana Nicholas ◽  
Kenneth Nelson ◽  
Azmi Sarriff
Keyword(s):  
Heart Disease ◽  
Case Report ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Systemic Vasculitis ◽  
Cervical Lymphadenopathy ◽  
Pharmaceutical Journal ◽  
Infectious Agents ◽  
School Aged Children ◽  
Acquired Heart Disease

disease (KD) is an acute systemic vasculitis that predominantly affects pre-school aged children. It is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy, and irritation and inflammation of the mouth, lips, and throat. Serious complications of KS include coronary artery dilatations and aneurysms, and KS is a leading cause of acquired heart disease. It has a predilection to coronary arteries, and its precise etiology is still unknown. Many infectious agents, including viruses and bacteria, have been suggested as potential causes of the disease.DOI: http://dx.doi.org/10.3329/icpj.v1i8.11256 International Current Pharmaceutical Journal 2012, 1(8): 226-228 

scholarly journals Allograft Coronary Artery Thrombosis: A Case Report Of Early Cardiac Allograft Left Ventricular Myocardial Infarction

2012 ◽  
Vol 8 (1) ◽  
pp. 46-48 ◽  
Author(s):  
Sergio A. Torres ◽  
Omar Cheema ◽  
Dipan J. Shah ◽  
Guillermo Torre-Amione ◽  
Jerry D. Estep
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Cardiac Allograft ◽  
Artery Thrombosis ◽  
Coronary Artery Thrombosis

scholarly journals The emergence of Kawasaki disease in India and China

2018 ◽  
Vol 2017 (3) ◽  
Author(s):  
Ankur Kumar Jindal ◽  
Vingesh Pandiarajan ◽  
Raju Khubchandani ◽  
Nutan Kamath ◽  
Tapas Sabui ◽  
...  
Keyword(s):  
Developing Countries ◽  
Heart Disease ◽  
Kawasaki Disease ◽  
Developed Countries ◽  
Resource Constrained ◽  
Diagnosis And Management ◽  
China And India ◽  
The World ◽  
Acquired Heart Disease ◽  
India And China

Kawasaki disease (KD) is recognized as a leading cause of acquired heart disease in children in developed countries. Although global in distribution, Japan records the highest incidence of KD in the world. Epidemiological reports from the two most populous countries in the world, namely China and India, indicate that KD is now being increasingly recognized. Whether this increased reporting is due to increased ascertainment, or is due to a true increase in incidence, remains a matter of conjecture. The diagnosis and management of KD in developing countries is a challenging proposition. In this review we highlight some of the difficulties faced by physicians in managing children with KD in resource-constrained settings. 

scholarly journals Kawasaki Disease: A Clinician’s Update

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Nathan Jamieson ◽  
Davinder Singh-Grewal
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Reference Lists ◽  
Systemic Vasculitis ◽  
Clinical Criteria ◽  
Treatment Practices ◽  
Fever Onset ◽  
Environmental Trigger ◽  
Acquired Heart Disease ◽  
Developed World

Aims. Kawasaki disease is an acute systemic vasculitis and is the most common cause of acquired heart disease in children in the developed world. This review aims to synthesise recent insights into the disease and provide an update for clinicians on diagnostic and treatment practices.Methods. We conducted a review of the literature exploring epidemiology, aetiology, diagnosis, and management of Kawasaki disease. We searched MEDLINE, Medline In-Process, Embase, Google Scholar, and reference lists of relevant articles.Conclusions. Kawasaki disease is a febrile vasculitis which progresses to coronary artery abnormalities in 25% of untreated patients. The disease is believed to result from a genetically susceptible individual’s exposure to an environmental trigger. Incidence is rising worldwide, and varies widely across countries and within different ethnic groups. Diagnosis is based on the presence of fever in addition to four out of five other clinical criteria, but it is complicated by the quarter of the Kawasaki disease patients with “incomplete” presentation. Treatment with intravenous immunoglobulin within ten days of fever onset improves clinical outcomes and reduces the incidence of coronary artery dilation to less than 5%. Given its severe morbidity and potential mortality, Kawasaki disease should be considered as a potential diagnosis in cases of prolonged paediatric fever.

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