| Objective:To investigate the treatment and impacts regarding late or missed diagnosis of Kawasaki disease in not only young children but also in adult population.Kawasaki disease is known to often occur in children below five years of age,and more specifically in male children and infants of Asian ethnicities.The acute ailment has been increasingly prevalent despite new era’s modern technology and medicine.Given this trend,this thesis intended to shine a light on disease progression and describe the recommended procedures for medical personnel in the management of Kawasaki Disease(KD).A review of the English literature was preformed to better understand the disease progression and define the treatment options available for the patient.A retrospective analysis of a patient seen at the Shandong University Qilu Hospital was done,including clinical manifestation,medical intervention and outcome analysis.Study was done mainly to evaluate the long term effects of KD in adults.Methods:The clinical data of almost 22 patients with Kawasaki disease ranging from 04 to 18 years of follow up were analyzed retrospectively,and the prognosis of the patients who underwent treatment was evaluated.Additionally,a case study was done on a male who was 18 year old university basketball player with a history of abnormal Q wave in V1-V4 during routine screening electrocardiography(ECG).He had no significant medical history except for a neglected month-long self-limiting fever and cervical lymphadenopathy at 7 years of age which was not diagnosed to be KD at that time.This asymptomatic patient was found to have deep Q waves in anterior leads on screening electrocardiography and was thought to have myocarditis after depiction of wall motion abnormality on echocardiography,later to be confirmed to have left anterior descending artery(LAD)territory infarct on cardiac magnetic resonance imaging.Coronary computed tomography angiogram depicted proximal LAD aneurysm with calcified plaque/thrombus.Additionally,there was an 18mm giant right coronary artery(RCA)aneurysm with braid-like appearance and soft plaque(mural thrombus).Investigations included modalities like CT,MRI,Echocardiography,ECG,percutaneous coronary intervention and other laboratory tests.Results:After 04-18 years of follow-up,the clinical symptoms,laboratory indicators and imaging manifestations of patients with Kawasaki disease were all analyzed and reported.Mostly the observed patients have complications related to heart such as aneurysms,angina,coronary stenosis,obstruction,acute thrombosis and MI.According to the risk stratification,the patient belonged to risk level Ⅴ(coronary artery obstruction).In those patients,cardiac catheterization with selective coronary angiography should be performed.Catheter interventions,such as balloon angioplasty,stent placement,or rotational ablation can be performed in a patient with true indications.Follow up,timely treatment and timely diagnosis by doctors can be the key to prevent cardiac complications in KD.Conclusion:Timely treatment and timely diagnosis by doctors can be the key in KD to effectively reduce cardiac complications in the patients.Kawasaki disease is one of the main causes of CADs in young adults that cannot infrequently be missed.Diagnosis of KD relies on five days of fever plus four of five diagnostic criteria to establish the diagnosis.The criteria are erythema of the lips or oral cavity,cracking of the lips,rash on the trunk,swelling or erythema of the hands or feet,red eyes(conjunctival injection)swollen lymph node in the neck of at least 15 mm.Kawasaki disease is one of the main causes of CADs in young adults that cannot infrequently be missed.An up-to-date knowledge of the disease and its consequences can minimize both delayed and missed diagnosis and aid timely management to prevent its life-threatening complications. |
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