Ruptured Mitral Chordae Tendineae Due to Incomplete Kawasaki Disease after Spontaneous Defervescence: A Case Report

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  • Matsuo Osamu
    Department of Pediatrics, Kumamoto University Graduate School of Medical Sciences
  • Miyamura Fumiya
    Department of Pediatrics, Kumamoto University Graduate School of Medical Sciences
  • Fukae Koji
    Department of Pediatric Cardiac Surgery, Kumamoto City Hospital
  • Komohara Yoshihiro
    Department of Cell Pathology, Kumamoto University Graduate School of Medical Sciences

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<p>Rupture of mitral chordae tendineae in the acute phase of Kawasaki disease is rare in infants, with a sudden onset and possible complication of acute heart failure. Herein, we report the case of a 7-month-old female with incomplete Kawasaki disease who was diagnosed with ruptured mitral chordae tendineae resulting in acute heart failure. The patient had a history of fever lasting for 6 days. She had no other symptoms suggestive of Kawasaki disease, and spontaneous defervescence was seen. She was brought to our hospital on the 14th day of the illness for acute heart failure. Severe mitral regurgitation due to ruptured chordae tendineae of the posteromedial leaflet was diagnosed using echocardiography. Aneurysmal dilatation of the proximal coronary artery was also observed. Based on the coronary arterial lesion and laboratory data, we diagnosed her with ruptured mitral chordae tendineae due to severe valvulitis resulting from incomplete Kawasaki disease. Artificial chordae reconstruction and Kay-Reed annuloplasty were performed on the 17th day of the illness, and her mitral regurgitation on echocardiography improved from severe to trivial. Although the ruptured mitral chordae tendineae is rare among infants, timely diagnosis and treatment are crucial to avoid life-threatening complications.</p>

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