Without treatment, what is the major cardiovascular complication of Kawasaki disease?

• A. Myocardial infarction
• B. Aortic dissection
• C. Valvular stenosis
• D. Coronary artery aneurysm

Answer: (D)

Kawasaki disease is a pediatric vasculitis that preferentially involves medium-sized arteries, especially the coronary arteries. When not treated promptly, inflammation weakens the vessel walls and leads to coronary artery aneurysm formation. These aneurysms are the major cardiovascular issue because they create areas of turbulent blood flow that promote thrombosis and later stenosis, putting the heart at risk for ischemia and infarction. Early heart involvement like myocarditis or pericarditis can occur, and valvular problems may develop over time, but the most significant long-term cardiovascular complication is coronary artery aneurysm. Without treatment, a substantial portion of patients develop these aneurysms, whereas timely IVIG markedly lowers that risk.