Regression of coronary aneurysms in Kawasaki disease

Regression of coronary aneurysms in Kawasaki disease

Factors which favour regression of coronary aneurysms in Kawasaki disease [1]:

1. Age less than one year at onset of Kawasaki disease
2. Smaller aneurysms have a greater chance of regression
3. Distal aneurysms are more likely to regress
4. Fusiform aneurysms regress more often than saccular aneurysms

Overall about half to two thirds of coronary aneurysms in Kawasaki disease have been shown to regress on angiography within one to two years of onset of illness.

In contrast to coronary aneurysms which can regress with time, stenotic lesions are more likely to progress as they are due to intense myointimal proliferation. Progression of stenotic lesions are more likely in those with giant aneurysms.

Worst prognosis is for those with giant aneurysms of 8 millimeters or more diameter [2].

Though echocardiography is the most commonly used investigation for aneurysms in Kawasaki disease and coronary angiography the gold standard, multi detector computed tomography (MDCT) is a useful non invasive modality for long term follow up [3].

References

1. Takahashi M, Mason W, Lewis AB. Regression of coronary aneurysms in patients with Kawasaki syndrome. Circulation. 1987;75:387-394.
2. Fujiwara T, Fujiwara H, Hamashima Y. Size of coronary aneurysm as a determinant factor of the prognosis in Kawasaki disease: clinicopathologic study of coronary aneurysms. Prog Clin Biol Res. 1987;250:519-520.
3. Khositseth A, Siripornpitak S, Pornkul R, Wanitkun S. Khositseth A, Siripornpitak S, Pornkul R, Wanitkun S. Br J Radiol. 2008 Apr;81(964):e106-9.