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Unexpected late-onset aortic valvulitis and moderate regurgitation during longitudinal evaluation of atypical infantile Kawasaki disease: The heart beyond coronaries!


1 Department of Pediatric Cardiology, Manipal Hospital, Bengaluru, Karnataka, India
2 School of Medicine, University of Nottingham, Nottingham, UK
3 Department of Pediatric and Neonatal Services, Cloud Nine Hospitals, Bengaluru, Karnataka, India
4 Department of Pediatric Cardiology, LLRM Medical College, Meerut, Uttar Pradesh, India

Correspondence Address:
Maitri Chaudhuri
Manipal Hospital, #98, HAL Airport Road, Bengaluru - 560 017, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.APC_182_20

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Year : 2021  |  Volume : 14  |  Issue : 3  |  Page : 428-431

 

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Kawasaki disease (KD) is the most common pediatric vasculitis with coronary involvement feared as the most serious complication. The reported case describes a child presenting initially with atypical KD and coronary artery aneurysms. He was treated with intravenous immunoglobulin and aspirin. In spite of adequate compliance and no clinical recurrence, serial echocardiography revealed nonregression of aneurysm and new-onset moderate aortic regurgitation (AR) in the subacute phase produced by prolapse of noncoronary cusp of the aortic valve. AR without aortic root dilatation from persistent inflammation of the valve leaflets in KD is a rare phenomenon. This case demonstrates unusual cardiac manifestations of KD and reoriented our protocol for long-term surveillance in infantile KD.






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1 Department of Pediatric Cardiology, Manipal Hospital, Bengaluru, Karnataka, India
2 School of Medicine, University of Nottingham, Nottingham, UK
3 Department of Pediatric and Neonatal Services, Cloud Nine Hospitals, Bengaluru, Karnataka, India
4 Department of Pediatric Cardiology, LLRM Medical College, Meerut, Uttar Pradesh, India

Correspondence Address:
Maitri Chaudhuri
Manipal Hospital, #98, HAL Airport Road, Bengaluru - 560 017, Karnataka
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.APC_182_20

Rights and Permissions

Kawasaki disease (KD) is the most common pediatric vasculitis with coronary involvement feared as the most serious complication. The reported case describes a child presenting initially with atypical KD and coronary artery aneurysms. He was treated with intravenous immunoglobulin and aspirin. In spite of adequate compliance and no clinical recurrence, serial echocardiography revealed nonregression of aneurysm and new-onset moderate aortic regurgitation (AR) in the subacute phase produced by prolapse of noncoronary cusp of the aortic valve. AR without aortic root dilatation from persistent inflammation of the valve leaflets in KD is a rare phenomenon. This case demonstrates unusual cardiac manifestations of KD and reoriented our protocol for long-term surveillance in infantile KD.






[FULL TEXT] [PDF]*


        
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