Kawasaki disease - Complications of Kawasaki disease

With prompt treatment, most children with Kawasaki disease make a full recovery. However, sometimes complications can develop.

The complications associated with Kawasaki disease are mainly related to the heart. They occur as a result of the inflammatory effect that the condition has on the blood vessels.

Aneurysm

Inflammation in the coronary arteries (the blood vessels that supply blood to the heart) can cause a section of the artery wall to weaken.

As the blood passes through the weakened part of the artery wall, the blood pressure causes it to bulge outwards like a balloon. This is called an aneurysm.

Some aneurysms heal by themselves over time. However, sometimes a blood clot (thrombosis) can form in a weakened section of the artery.

This can cause a heart attack (where part of the heart muscle dies because it is starved of oxygen) or heart disease (where the heart's blood supply is blocked or interrupted).

In rare cases, the aneurysm can rupture (burst), which could cause severe internal bleeding.

It is also possible for other major arteries to be affected, such as the brachial artery (the main blood vessel in the upper arm) or the femoral artery (the main blood vessel in the upper thigh).

Risks

Around 25% of children with Kawasaki disease who don't receive treatment (because the condition has been diagnosed incorrectly, for example) go on to experience heart-related complications.

For children who receive intravenous immunoglobulin (IVIG) to treat Kawasaki disease, their risk of developing complications is reduced to 5%.

The heart-related complications associated with Kawasaki disease are serious and in 1% of cases they may be fatal. Children under one year old are thought to be at a higher risk of serious complications.

Treating complications

If your child develops a serious heart abnormality, they may require medication or, in some cases, surgery. Possible treatments include:

• anticoagulant medicines and antiplatelet medicines: medicines that stop the blood from clotting, which may prevent your child having a heart attack if their arteries are particularly inflamed
• coronary artery bypass graft: surgery to divert blood around narrow or clogged arteries and improve the blood flow and oxygen supply to the heart
• coronary angioplasty: a procedure to widen blocked or narrowed coronary arteries to improve the blood flow to the heart; in some cases, a stent (a short, hollow metal tube) is inserted into the blocked artery to keep it open

Children with severe complications may have permanent damage to their heart muscles or valves (the flaps that control the flow of blood). They will have regular follow-up appointments with a heart specialist (cardiologist) so that their condition can be closely monitored.

Complications in later life

If your child has had heart complications as a result of Kawasaki disease, they may have an increased risk of developing cardiovascular complications later in life. This includes conditions such as heart attacks and heart disease.

The cardiologist will be able to advise you about your child's likelihood of developing further heart-related problems.