Case Report

CT angiography indication in the follow-up of a Kawasaki patient: A case Report

CT angiography indication in KD

Abstract

Background: Kawasaki disease (KD) is a vasculitis that primarily affects young children and results coronary artery abnormalities. Echocardiography is the standard imaging modality for monitoring KD patients; however, some coronary artery anomalies are not detected by using this method. This case report demonstrates the significance of CT angiography in identifying previously undiagnosed coronary abnormalities in a KD patient.

Case Presentation: A 7-year-old male presented with symptoms consistent with KD was treated subsequently with intravenous immune globulin (IVIG). Follow-up echocardiography showed no significant coronary artery abnormalities. Three years later, the patient presented with flu-like symptoms, and an ECG revealed anterolateral ischemic changes. Echocardiography showed normal coronary arteries, but a CT angiogram was performed due to the ischemic changes on ECG. The CT angiogram identified a myocardial bridge in the left anterior descending artery (LAD), which had not been detected by echocardiography or ECG.

Conclusion: This case report emphasizes on importance of considering CT angiography as an adjunct imaging modality in the evaluation and follow-up of KD patients, particularly when echocardiography findings are inconclusive or when clinical presentation raises concerns for potential coronary artery abnormalities. Further research is needed to establish evidence-based guidelines for the optimal timing and clinical indications for CT angiography in Kawasaki disease patients.

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SectionCase Report(s)
Keywords
Kawasaki CT angiography Echocardiography Myocardial bridge.
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1.
Akbariasbagh P, Raeeskarami S-R, Asgar-Shirazi M, Adib M. CT angiography indication in the follow-up of a Kawasaki patient: A case Report. J Tehran Heart Cent. 2024;.