Aortic and mitral regurgitation in an infant with Kawasaki disease

A fatal case of Kawasaki disease with extensive cardiac involvement in an 11-week-old boy is described. Two-dimensional echocardiography revealed enlargement of the left ventricle, left atrium, and aortic root as well as dilatation of the left main coronary artery. Cardiac catheterization revealed both aortic and mitral regurgitation and fusiform dilatation of the proximal segments of the coronary arteries. The clinical course was characterized by multi-system failure and death on day 31 of the illness. Aortic regurgitation is a very rare complication of Kawasaki disease and has been previously reported in one Japanese infant. The pathogenesis of aortic regurgitation in this disease is not known but may be due to aortitis and/or valvulitis. Kawasaki disease should be included as a cause of aortic regurgitation in infants.