Review of Kawasaki Disease

Abstract Background: Kawasaki disease is one of the leading causes of acquired heart disease in children. It is an acute self-limited vasculitis that predominantly affects infants and children younger than 5 years of age. These patients present with nonspecific symptoms, such as fever and lymphadenopathy, making the diagnosis challenging. This disease can have serious and potentially fatal outcomes, and prompt recognition of this disease is vital to the patient’s outcome. We present a complete review of the disease, including the epidemiology, pathophysiology, diagnosis and management of acute Kawasaki disease, the natural history of this disease, and follow up of these patients as they transition into the adult cardiology practice. Methods: Our systematic review information were collected from articles retrieved from PubMed library. Keywords that were used included; Kawasaki disease, coronary artery disease, coronary artery aneurysm, pediatric coronary artery disease, epidemiology of Kawasaki disease and treatment of Kawasaki disease. We included only relevant to the topic articles. No exclusion criteria were applied. Conclusions: Kawasaki disease incidence tends to be increasing over the last decade in the united states. Seasonality of the disease has been described in Japan. It is a mysterious disease with unknown etiology, however, multiple hypotheses have been proposed and tested to explain the pathophysiology. As this disease has an associated high morbidity and mortality, prompt recognition and management of this disease is important to the patient’s overall prognosis and survival

Paradigm shifts: Efficacy of CABG for diabetic patients with coronary artery disease and prior PCI, and the utility of artificial intelligence in clinical decision-making

A clinical decision report using: Thielmann M, Neuhäuser M, Knipp S, et al. Prognostic impact of previous percutaneous coronary intervention in patients with diabetes mellitus and triple-vessel disease undergoing coronary artery bypass surgery. J Thorac Cardiovasc Surg. 2007;134(2):470-476. https://doi.org/10.1016/j.jtcvs.2007.04.019 for a patient with prior coronary artery catheterization being referred for surgical intervention, and a clinician encountering a nonexistent clinical reference hallucinated by a large language model

Exercise management in type 1 diabetes:a consensus statement

Type 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of different forms of physical activity is particularly difficult for both the individual with type 1 diabetes and the health-care provider. People with type 1 diabetes tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass nor achieving the minimum amount of moderate to vigorous aerobic activity per week. Regular exercise can improve health and wellbeing, and can help individuals to achieve their target lipid profile, body composition, and fitness and glycaemic goals. However, several additional barriers to exercise can exist for a person with diabetes, including fear of hypoglycaemia, loss of glycaemic control, and inadequate knowledge around exercise management. This Review provides an up-to-date consensus on exercise management for individuals with type 1 diabetes who exercise regularly, including glucose targets for safe and effective exercise, and nutritional and insulin dose adjustments to protect against exercise-related glucose excursions

Left Ventricular Noncompaction Syndrome: A Rare Congenital Cardiomyopathy

Isolated left ventricular noncompaction cardiomyopathy (LVNC) is a rare congenital condition occurring due to arrest of myocardial compaction in the first trimester, resulting in a thin layer of compacted epicardium and thick hypertrabeculated myocardium containing deep recesses. This article presents a 44-year-old female with progressive dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and pleuritic chest pain. Examination revealed elevated jugular venous distention, lower extremity edema, and bibasilar crackles on lung auscultation, while the electrocardiogram (EKG) exhibited left bundle branch block. Two-dimensional echocardiography (2D-Echo) showed a dilated left ventricle (LV) with ejection fraction (EF) of 25% and severe diffuse hypokinesia. Cardiac magnetic resonance imaging (MRI) confirmed the diagnosis of LVNC. Thereafter, she developed atrial fibrillation with rapid ventricular rate. Conservative treatment was initiated with Tikosyn, Xarelto, Lasix, Toprol XL, Lisinopril, statin and life vest. Eventually, a cardiac resynchronization therapy defibrillator (CRT-D) was implanted to prevent sudden cardiac death and reduce heart failure complications

Left Ventricular Noncompaction Syndrome: A Rare Congenital Cardiomyopathy

Isolated left ventricular noncompaction cardiomyopathy (LVNC) is a rare congenital condition occurring due to arrest of myocardial compaction in the first trimester, resulting in a thin layer of compacted epicardium and thick hypertrabeculated myocardium containing deep recesses. This article presents a 44-year-old female with progressive dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and pleuritic chest pain. Examination revealed elevated jugular venous distention, lower extremity edema, and bibasilar crackles on lung auscultation, while the electrocardiogram (EKG) exhibited left bundle branch block. Two-dimensional echocardiography (2D-Echo) showed a dilated left ventricle (LV) with ejection fraction (EF) of 25% and severe diffuse hypokinesia. Cardiac magnetic resonance imaging (MRI) confirmed the diagnosis of LVNC. Thereafter, she developed atrial fibrillation with rapid ventricular rate. Conservative treatment was initiated with Tikosyn, Xarelto, Lasix, Toprol XL, Lisinopril, statin and life vest. Eventually, a cardiac resynchronization therapy defibrillator (CRT-D) was implanted to prevent sudden cardiac death and reduce heart failure complications

Review of Kawasaki Disease

Background: Kawasaki disease is one of the leading causes of acquired heart disease in children. It is an acute self-limited vasculitis that predominantly affects infants and children younger than 5 years of age. These patients present with nonspecific symptoms, such as fever and lymphadenopathy, making the diagnosis challenging. This disease can have serious and potentially fatal outcomes, and prompt recognition of this disease is vital to the patient’s outcome. We present a complete review of the disease, including the epidemiology, pathophysiology, diagnosis and management of acute Kawasaki disease, the natural history of this disease, and follow up of these patients as they transition into the adult cardiology practice. Methods: Our systematic review information were collected from articles retrieved from PubMed library. Keywords that were used included; Kawasaki disease, coronary artery disease, coronary artery aneurysm, pediatric coronary artery disease, epidemiology of Kawasaki disease and treatment of Kawasaki disease. We included only relevant to the topic articles. No exclusion criteria were applied. Conclusions: Kawasaki disease incidence tends to be increasing over the last decade in the united states. Seasonality of the disease has been described in Japan. It is a mysterious disease with unknown etiology, however, multiple hypotheses have been proposed and tested to explain the pathophysiology. As this disease has an associated high morbidity and mortality, prompt recognition and management of this disease is important to the patient’s overall prognosis and survival