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This report describes a 19-month-old boy whose progressive illness culminated in sudden cardiac arrest after misdiagnosis as viral infection and pneumonia, causing prolonged resuscitation and multiorgan dysfunction. Imaging showed giant bilateral coronary aneurysms with thrombosis, treated with multimodal intensive therapy.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/cardiac-arrest-as-initial-presentation-of-kawasaki-disease-with-giant-coronary-aneurysms-a-case-report-and-review-of-literature/406820/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/cardiac-arrest-as-initial-presentation-of-kawasaki-disease-with-giant-coronary-aneurysms-a-case-report-and-review-of-literature/406820.png","ImageObject",300,407,{"name":92,"@type":93},"Alexandar","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why was Kawasaki disease initially missed in this case?","Question",{"text":113,"@type":114},"Early fever, cough, and rash were repeatedly treated as viral infection and pneumonia, delaying recognition of KD.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What did echocardiography show after admission?",{"text":118,"@type":114},"Echocardiography demonstrated giant bilateral coronary aneurysms with right coronary artery thrombosis, consistent with KD complicated by myocardial infarction.",{"name":120,"@type":111,"acceptedAnswer":121},"What treatments were used to manage severe KD with cardiac arrest?",{"text":122,"@type":114},"Management included mechanical ventilation, high-dose vasopressors, intravenous immunoglobulin, corticosteroids, anticoagulation, antibiotics, continuous renal replacement therapy, targeted temperature management, and therapeutic plasma exchange.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},406820,1790793276,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":41,"preview_page_count":4},962090768658,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","| W | J | C | C | World Journal of\u003Cbr>Clinical Cases |\n| --- | --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Clin Cases 2025 December 26; 13(36): 114472  \nDOI: 10.12998/wjcc.v13.i36.114472 ISSN 2307-8960 (online)  \nCASE REPORT  \nCardiac arrest as initial presentation of Kawasaki disease with giant coronary aneurysms: A case report and review of literature  \nDat Minh-Tan Truong, Liem Thanh Bui, Tam Khiet Nguyen, Hieu Trong Pham, Bao Quoc Vo, Thanh Tat Nguyen  \nSpecialty type: Critical care medicine  \nProvenance and peer review:  \nInvited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade C  \nNovelty: Grade D  \nCreativity or Innovation: Grade D  \nScientific Significance: Grade C  \nP-Reviewer: Truyen TTTT, MD, Researcher, United States  \nReceived: September 22, 2025  \nRevised: October 20, 2025  \nAccepted: December 11, 2025  \nPublished online: December 26, 2025  \nProcessing time: 96 Days and 17.4 Hours  \nDat Minh-Tan Truong, Liem Thanh Bui, Hieu Trong Pham, Bao Quoc Vo, Department of Intensive Care Unit, Children’s Hospital 2, Ho Chi Minh City 700000, Viet Nam  \nLiem Thanh Bui, Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City 700000, Viet Nam  \nTam Khiet Nguyen, Department of Cardiology, Children’s Hospital 2, Ho Chi Minh City 700000, Viet Nam  \nThanh Tat Nguyen, Department of Infectious Diseases, Children’s Hospital 2, Ho Chi Minh City 700000, Viet Nam  \nCo-first authors: Dat Minh-Tan Truong and Liem Thanh Bui.  \nCorresponding author: Thanh Tat Nguyen, MD, PhD, Senior Researcher, Department of Infectious Diseases, Children’s Hospital 2, Ly Tu Trong, Ho Chi Minh City 700000, Viet Nam.  \n[thanhhonor@gmail.com](thanhhonor@gmail.com)  \nAbstract  \nBACKGROUND  \nKawasaki disease (KD) is an acute systemic vasculitis in young children that may cause coronary aneurysms, thrombosis, myocardial infarction, and sudden death if diagnosis is delayed.  \nCASE SUMMARY  \nWe report a 19-month-old male patient who presented after 25 days of progressive illness culminating in sudden cardiac arrest. Initial episodes of fever, cough, and rash were misdiagnosed as viral infection and pneumonia, delaying recognition. On admission following prolonged resuscitation, he was comatose with severe metabolic acidosis, multiorgan dysfunction, and periungual desquamation. Echocardiography demonstrated giant bilateral coronary aneurysms with right coronary artery thrombosis, consistent with KD complicated by myocardial infarction. Management included mechanical ventilation, high-dose vasopressors, intravenous immunoglobulin, corticosteroids, anticoagulation, and antibiotics. Continuous renal replacement therapy, targeted temperature management, and therapeutic plasma exchange were employed to control cytokine storm and organ failure. The patient stabilized hemodynamically, was extubated by day 12, and subsequently transferred for cardiology care. Follow-up imaging confirmed per-  \n WJCC  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 26, 2025  Volume 13  Issue 36   \nTruong DMT et al. Cardiac arrest from Kawasaki coronary aneurysms  \nsistent aneurysms without thrombosis, preserved cardiac function, and favorable neurological recovery.  \nCONCLUSION  \nThis case underscores the challenges of recognizing atypical KD and highlights the importance of early suspicion, rapid resuscitation, and multimodal therapies, including Continuous renal replacement therapy and therapeutic plasma exchange, in improving survival and neurological outcomes.  \nKey Words: Kawasaki disease; Cardiac arrest; Coronary artery aneurysm; Continuous renal replacement therapy; Therapeutic plasma exchange; Viet Nam; Case report  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \nCore Tip: Kawasaki disease (KD) is a childhood illness that can damage the heart if not recog","cbCaimo3qQolY9Sh","https://ap.wps.com/l/cbCaimo3qQolY9Sh","pdf",4372020,12,"English","# Abstract\n## Background\n## Case summary\n## Conclusion\n# Core tip\n# Introduction","[{\"question\":\"Why was Kawasaki disease initially missed in this case?\",\"answer\":\"Early fever, cough, and rash were repeatedly treated as viral infection and pneumonia, delaying recognition of KD.\"},{\"question\":\"What did echocardiography show after admission?\",\"answer\":\"Echocardiography demonstrated giant bilateral coronary aneurysms with right coronary artery thrombosis, consistent with KD complicated by myocardial infarction.\"},{\"question\":\"What treatments were used to manage severe KD with cardiac arrest?\",\"answer\":\"Management included mechanical ventilation, high-dose vasopressors, intravenous immunoglobulin, corticosteroids, anticoagulation, antibiotics, continuous renal replacement therapy, targeted temperature management, and therapeutic plasma exchange.\"}]","Cardiac arrest as initial presentation of Kawasaki disease with giant coronary aneurysms - A case report and review of literature | PDF",1790568180]