Coronary aneurysm in Kawasaki syndrome: incidence and prognosis

Out of 10 pediatric patients with coronary aneurysms after Kawasaki-syndrome 9 were reinvestigated 1 to 9 years after their initial illness. Out of 21 aneurysms of all types and sizes 2 showed early and 1 late, silent thrombosis leading to myocardial infarction. 8 aneurysms regressed spontaneously and another 8 became smaller. The tendency to regress or to decrease in diameter war greatest in the group of patients with a low Asai-Score and initially small aneurysms. Myocardial infarction was only seen in the group of giant aneurysms (over 8 mm of diameter). A simple prophylaxis with anti-platelet agents does not seem to be adequate especially in over-sized aneurysms. Those should be prevented now by gamma-globulin therapy. If they occur, however, thrombosis should be prevented by the use of anticoagulants.