Choose a medical condition from the cardiovascular system and lymphatic system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder?

Choose a medical condition from the cardiovascular system and lymphatic system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder?

Choose a medical condition from the cardiovascular system and lymphatic system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder?

Kawasaki Disease

            Kawasaki Disease (KD) is one of the most common childhood vasculitis syndromes.  Besides the other clinical presentations of the disease, it often progresses to coronary artery syndrome when left untreated (Hara et al., 2021).  There is evidence of a reduction of coronary artery lesions following the administration of immunoglobulins (Hara et al., 2021; Noval Rivas & Arditi, 2020a). Despite the efforts that have been made to improve the therapeutic outcomes and prognosis of KD, it is still the leading cause of the majority of cardiovascular diseases that are acquired in childhood in the developed world.

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Pathophysiology

            The anatomy of a normal coronary artery is made up of three layers namely tunica intima, tunica media and tunica adventitia.  The intima is composed of endothelial cells, the tunic media made of smooth muscle cells while the adventitia contains the loose connective tissue (Hara et al., 2021). It should be noted that during the first two weeks of the KD, necrotizing arteritis develops leading to the infiltration of neutrophils which causes significant damage to the whole of the intima and media and some parts of the adventitia (Hara et al., 2021).  During subacute chronic arteritis, the inflammatory infiltration is composed of macrophages, CD8⁺ T cells, monocytes and IgA⁺ plasma cells (Noval Rivas & Arditi, 2020b). Based on the research findings of Hara et al. (2021), this cells release pro-inflammatory cytokines such as Interleukin-beta and tumour necrosis factors (TNF) which contribute to the luminal myoblasts proliferation from the smooth muscle cells and their matrix products cause occlusion of the coronary artery.

Patient Advice

            Parents should be educated on the clinical presentations of KD such as high fever, skin rash as well as peeling, eye redness (conjunctivitis), swollen neck lymph nodes and peeling of the skin on the hands and feet (Hara et al., 2021).  Additionally, the patients or caregivers should be informed to be on the lookout for such changes in the mouth such as red throat or tongue.  The child might be very irritable. After diagnosis assure the patient and their caregivers that the condition can be managed using NSAIDs and immunoglobulins.

            In conclusion, KD is one of the leading causes of coronary artery disease among children, especially in developed countries. The pathophysiology of KD entails the infiltration of the coronary artery wall through a wide range of adaptive and innate immune cell responses.  Parents should observe their kids for any signs and symptoms of KD and seek medical attention as soon as possible

References

Hara, T., Yamamura, K., & Sakai, Y. (2021). The up‐to‐date pathophysiology of Kawasaki disease. Clinical & Translational Immunology, 10(5), e1284. https://doi.org/10.1002/cti2.1284

Noval Rivas, M., & Arditi, M. (2020a). Kawasaki disease: Pathophysiology and insights from mouse models. Nature Reviews. Rheumatology, 16(7), 391–405. https://doi.org/10.1038/s41584-020-0426-0

Noval Rivas, M., & Arditi, M. (2020b). Kawasaki disease: Pathophysiology and insights from mouse models. Nature Reviews. Rheumatology, 16(7), 391–405. https://doi.org/10.1038/s41584-020-0426-0

Choose a medical condition from the cardiovascular system and lymphatic system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder?