Coronary Artery Diseases of Childhood / 한양의대학술지

ABSTRACT

Coronary artery diseases in childhood are much less frequently seen than in adulthood. Kawasaki disease is the most prevalent cause of coronary diseases in children. Other significant diseases have congenital origin. These are the coronary arterial fistula and the anomalous origin of left coronary artery from pulmonary artery. Congenital coronary arterial fistulas are rare anomalies. Coronary arterial anatomy can be diagnosed correctly on the echocardiogram. The origin, course, and termination of coronary arterial fistula have to be well demonstrated. Coronary arterial fistulas have been managed by surgical ligation. In recent years, transcatheter coil embolization has been employed with good results. Anomalous origin of the left coronary artery from the pulmonary artery is rare. According to clinical pattern, infantile type and adult type can be classified. It may result in myocardial infarction, congestive heart failure, and sometimes death during the early infantile period. It is more rare in the adulthood. Coronary angiography establishes the diagnosis. There are several surgical options including reimplantation of the left main coronary into the aorta. Early surgical correction is important to preserve cardiac function. Kawasaki disease is an acquired and acute self-limited vasculitis of childhood. Kawasaki disease is characterized by fever, bilateral non-exudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia can develop in untreated children. Intravenous gamma globulin and aspirin were the standard therapy. Recently incomplete Kawasaki disease has been frequently diagnosed. New guidelines have developed in Japan and United States of America.