Which of the following best describes the coronary artery pathology in Kawasaki disease?

Which of the following best describes the coronary artery pathology in Kawasaki disease?

• A. Aneurysm formation due to transmural vasculitis of medium-sized arteries
• B. Thrombosis within the coronary veins
• C. Suppurative endocarditis of the left ventricle
• D. Fibrous calcification of coronary arteries

Answer: (C)

Kawasaki disease causes a distinct artery-focused vasculitis: inflammation that goes through all layers of medium-sized arteries, especially the coronary arteries. This transmural vasculitis weakens the vessel wall, leading to the formation of coronary artery aneurysms. Over time, healing can bring intimal proliferation and potential narrowing of the vessel, which raises the risk of thrombosis and myocardial ischemia in affected children. This arterial, aneurysm-forming process is why the best description centers on aneurysm formation from transmural involvement of the coronary arteries, rather than venous thrombosis, endocarditis, or calcification of the arteries.

Kawasaki disease causes a distinct artery-focused vasculitis: inflammation that goes through all layers of medium-sized arteries, especially the coronary arteries. This transmural vasculitis weakens the vessel wall, leading to the formation of coronary artery aneurysms. Over time, healing can bring intimal proliferation and potential narrowing of the vessel, which raises the risk of thrombosis and myocardial ischemia in affected children. This arterial, aneurysm-forming process is why the best description centers on aneurysm formation from transmural involvement of the coronary arteries, rather than venous thrombosis, endocarditis, or calcification of the arteries.