Mucocutaneous lymph node syndrome: clinical, hemodynamic and angiographic features of coronary obstructive disease.

Clinical, hemodynamic and angiographic features of coronary obstructive disease (greater than or equal to 90% diameter reduction) in Kawasaki disease were evaluated in 30 patients. The mean age at the onset of Kawasaki disease was 2.9 +/- 1.9 years and that at cardiac catheterization was 6.3 +/- 2.8 years. Obstructive lesions were observed in the right coronary artery in 12 patients (group 1), in the left anterior descending coronary artery (LAD) in 6 (group 2), in both right coronary artery and LAD in 10 (group 3) and in the left main coronary artery in 4 (group 4). Twenty-two patients (73%) had cardiac symptoms, including myocardial infarction in 10 (33%). Cardiac symptoms were observed in 41% in group 1, 100% in group 2, 80% in group 3 and 100% in group 4. Left ventricular (LV) end-diastolic pressure, end-diastolic volume and ejection fraction were abnormal in 32% of the patients in group 1, a frequency less than that in other groups (83% in group 2, 78% in group 3 and 100% in group 4). Fifty percent had mitral regurgitation and 73% had left ventricular wall motion abnormalities. No patient in groups 1 or 2 has died, but 8 of 14 patients in groups 3 and 4 have died. These observations indicate that coronary obstruction owing to Kawasaki disease can cause depressed LV function, mitral regurgitation and LV wall motion abnormalities in children.(ABSTRACT TRUNCATED AT 250 WORDS)