The long-term heart risks of Kawasaki disease in children

The inflamed blood vessels that can accompany Kawasaki disease in children can give rise to a variety of heart issues that make it the leading cause of acquired heart disease in children.

Fortunately, cardiovascular health returns to normal within a couple months for the vast majority of patients.

Lasting complications from Kawasaki disease, however, can include heart valve issues, abnormal heartbeat rhythm, inflammation of the heart muscle, and aneurysms.

These lasting heart conditions are rare. Less than 2% of patients experience coronary artery enlargement that carries over into adulthood. However, when complications do persist, they can impact patients long after childhood symptoms of the disease have subsided.

“Unfortunately, young adults often will consider a childhood disease as ancient history. They feel fine now and consider themselves cured,” said Walter L. Sobczyk, M.D., pediatric cardiologist with Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, and an adult congenital heart disease specialist. “But in reality, they may still have a dangerous heart condition that can strike with little warning, and they need to stay on top of their health.”

Managing the long-term effects of Kawasaki disease

In many cases, anti-platelet therapy to prevent blood cells from sticking together and clotting reduces the risk of stroke or heart attack.

Those who have lasting complications should avoid playing contact sports due to potential for uncontrolled bleeding from the anti-clotting treatments.

Patients should have regular checkups for risk assessments every couple of years.

“Adults with a history of coronary artery involvement due to Kawasaki disease should have

lifelong engagement with a specialist familiar with Kawasaki disease,” Dr. Sobczyk said.

Those with heart issues resulting from Kawasaki disease should avoid a sedentary lifestyle. Inactivity is just as dangerous as overactivity, because it allows clots to form in arteries.

Patients typically should make health-conscious lifestyle decisions, such as refraining from smoking, maintaining a diet low in fat and cholesterol, limiting alcohol consumption and controlling their blood pressure. Reproductive health counseling is recommended for female Kawasaki disease patients.

While Kawasaki disease can present long-term challenges to adults, these obstacles can be overcome with mindfulness, determination and collaboration with medical professionals.