Occlusion of the right coronary artery as sequelae of Kawasaki disease: the clinical features of 9 cases.

Among the 302 children with Kawasaki disease (KD) who were evaluated by angiography from 1973 through 1992, 9 (3.0%) had either an occlusion (OC) or segmental stenosis (SS) of the right coronary artery. The interval from the onset of KD to the recognition of OC or SS ranged from 0.5 to 7.7 years (median 4.0 years). Left coronary arterial lesions were also present in 8 of 9 patients. In spite of severe sequelae, children or young adolescents with cardiovascular system-related symptoms were unexpectedly rare. Asymptomatic patients, however, are also at risk of developing myocardial infarction since they have been shown to have a high rate of abnormalities on myocardial scintigraphy. A close observation and careful follow-up are thus considered to be indispensable.