From the Guidelines
Kawasaki disease is the most significant cause of acquired heart disease in children, in addition to acute rheumatic fever, rheumatic heart disease, complications in previously treated congenital heart disease, myocarditis, arrhythmias, cardiomyopathy, and endocarditis. This condition is an acute, self-limited vasculitis that predominantly affects children under five years of age and can lead to coronary artery aneurysms in approximately 25% of untreated cases 1. The diagnosis of Kawasaki disease is based on the identification of principal clinical findings and the exclusion of other clinically similar entities with known causes 1. Treatment involves intravenous immunoglobulin (IVIG) at 2g/kg as a single infusion, along with high-dose aspirin (80-100mg/kg/day divided into four doses) during the acute phase, followed by low-dose aspirin (3-5mg/kg/day) for 6-8 weeks after fever resolution 1. Early treatment, ideally within 10 days of fever onset, significantly reduces the risk of coronary complications 1. Kawasaki disease causes inflammation of blood vessels throughout the body, particularly affecting the coronary arteries, which can lead to aneurysm formation, thrombosis, stenosis, or myocardial infarction 1. Long-term cardiac monitoring is essential for children who develop coronary abnormalities, as these complications may persist into adulthood 1. Therefore, Kawasaki disease is the correct answer, as it is a significant cause of acquired heart disease in children, in addition to the other conditions mentioned.
From the Research
Acquired Heart Disease in Australian Children
The common causes of acquired heart disease in Australian children include:
- Acute rheumatic fever
- Rheumatic heart disease
- Complications in previously treated congenital heart disease
- Myocarditis
- Arrhythmias
- Cardiomyopathy
- Endocarditis In addition to these causes, another significant cause of acquired heart disease in children is:
- Kawasaki disease
Evidence from Studies
Studies have shown that Kawasaki disease is a leading cause of acquired heart disease in children, with a significant risk of coronary artery aneurysms and long-term cardiac complications 2, 3, 4, 5, 6. The disease is characterized by an acute vasculitis of unknown etiology, and treatment with intravenous gamma globulin and aspirin can reduce the risk of cardiac complications 2, 4. Kawasaki disease is now recognized as the most common cause of acquired heart disease in children in developed countries, and its incidence is increasing worldwide 3.