Children with Kawasaki are susceptible to coronary artery disease

Kawasaki disease is increasing in Vietnam in recent years. For every 2 children with this hospitalization late, there is a complication of coronary artery disease.

Red soles and hands are signs of Kawasaki disease.

Kawasaki is inflammation of small and medium blood vessels in the body, with persistent fever, rash, red lips, eyes, limbs . Beginning, in the acute phase, the blood vessels of the disease Children of Kawasaki will become inflamed on a small scale. If left untreated within 12 days, inflammation will spread throughout the blood vessels, causing aneurysms, blood clots and clots. Later, these lesions become nodular, granular and eventually scarring, which causes vascular fibrosis. At that time, blood vessels will not be able to deliver enough blood to the heart, leading to ischemic heart disease.

Kawasaki is the leading cause of coronary artery disease in children, which is one of the causes of sudden death and coronary insufficiency in the long term in adults. The disease is common in children under 5 years old, mainly 6-24 months. The earliest manifestation is unexplained high fever, sometimes the fever goes away on its own, but then relapses continuously.

In addition, the baby's eyes are red in blood, children often close their eyes due to the fear of light. Next is a very red lip, sometimes cracked and bleeding. The tongue is also red and thorny like a strawberry. Rashes in Kawasaki disease usually appear on the third to fifth day, starting at the limbs and spreading to the body. The rash is usually prominent when the fever is high.

When infected, children often do not hold on to anything and do not walk because of their palms, feet are red, limited from wrist, ankle down. After 2 weeks, the skin of the hands and feet will flake, starting from the fingers. In particular, children also have red erythema around the anus and skin in this place is similarly flaky after 2 weeks. Significant less noticeable signs in children with Kawasaki disease are lymph nodes on one side of the neck or under the jaw, which touch the child's lymph nodes with pain. Loosen the neck when fever subsides.

In the acute phase, in addition to the above signs, sometimes children have vomiting, diarrhea, fuss, cough, runny nose. If there is a vasculitis in the heart, the child shows signs of arrhythmia and may die in the first week.

Kawasaki disease is difficult to detect because symptoms often appear incomplete at the same time in the early stages. In the outbreak phase, the disease also has many different disorders in organs such as the digestive system, respiratory system; so it is easy to misdiagnose. Even if the disease heals itself, the doctor and the patient, even if the treatment is not right, still think it is right. In addition, because the neck of the child is short, the signs of neck lymph nodes sometimes appear unclear and difficult to touch. If the ultrasound of the neck is made, the diagnosis is easier.

Kawasaki disease occurs in children who are younger or older than 5 years old and the symptoms are more atypical. The fever manifests itself with several signs but is not adequate; even when the fever persists, relapses many times and is only detected when there is a heart complication. In addition to the clinical signs mentioned above, no test can help diagnose the disease. Therefore, parents need to watch carefully when they have a prolonged fever.

Cardiovascular complications

Cardiovascular complications may occur in the acute phase (within 2 weeks of onset of illness), subacute (after 4 to 8 weeks) or sequelae, which can last up to 13 years. Complications may include heart valve damage, heart muscle; It is common to change the size of coronary arteries, including aneurysms or narrowing. Coronary aneurysms are often unable to return to normal size; in the long run will lead to heart attacks, sudden death. Coronary heart disease is often difficult to treat. Requiring highly expensive techniques such as angioplasty, bypass surgery, and heart transplantation are not widely available at Children's hospitals.

Children are at risk of high coronary heart disease if they suffer from Kawasaki when they are less than 1 year old or older than 8 years old, especially boys. In addition, late hospitalized children, who are not treated in a timely manner or are unresponsive to treatment, are also at high risk. Kawasaki patients need to limit movement to avoid cardiovascular complications. Give your child a bed rest in the acute phase. Nutrition should be paid attention to because children have mouth sores, fussiness and anorexia. Drink plenty of water, eat your favorite foods, try to eat enough to increase your resistance.