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ECG abnormalities in Kawasaki disease and their value in predicting coronary artery aneurysms
Insights
Electrocardiogram (ECG) abnormalities are common in Kawasaki Disease, indicating carditis in most patients. However, ECG findings did not reliably predict coronary artery dilatation in this study.
Area of Science:
- Cardiology
- Pediatric Infectious Diseases
- Clinical Medicine
Background:
- Kawasaki Disease is a leading cause of acquired heart disease in children.
- Cardiac involvement, or carditis, is a significant complication.
- Early detection and risk stratification for coronary artery abnormalities are crucial.
Purpose of the Study:
- To investigate the prevalence of ECG abnormalities in children with Kawasaki Disease.
- To determine if ECG findings correlate with coronary artery dilatation.
- To assess the utility of the modified Asai scoring system in predicting coronary artery involvement.
Main Methods:
- Retrospective analysis of ECGs and echocardiograms in 25 patients with Kawasaki Disease.
- Documentation of specific ECG abnormalities, including S-T segments, Q/R ratio, and Q-T interval.
- Comparison of ECG findings between patients with and without coronary artery dilatation.
- Evaluation of the modified Asai scoring system's predictive value.
Main Results:
- ECG abnormalities suggestive of carditis were present in 80% of patients.
- Common abnormalities included raised S-T segments, increased Q/R ratio, and prolonged Q-T interval.
- Six patients (24%) had coronary artery dilatation, all with ECG carditis changes.
- ECG carditis changes were also present in 74% of patients with normal coronary arteries.
- The modified Asai scoring system did not prove useful in predicting coronary artery involvement.
Conclusions:
- ECG abnormalities are frequent in Kawasaki Disease and indicate carditis.
- ECG findings alone are not sufficient to predict coronary artery dilatation.
- The modified Asai scoring system showed limited utility in this patient cohort for risk stratification.
Abstract:
ECG abnormalities suggestive of carditis were encountered in 20 of 25 patients (80%) with Kawasaki Disease. The commonest abnormalities were raised S-T segments (11 patients), increased Q/R ratio (11 patients) and prolonged corrected Q-T interval (7 patients). Six patients had coronary artery dilatation and all resolved on subsequent 2-D Echocardiography. These six patients all had ECG changes of carditis. Such changes were present in 74% of patients with normal coronary arteries. The differences were not significant. A similar comparison between the two groups using the modified Asai scoring system failed to show the usefulness of this scoring system in predicting the risk of coronary artery involvement in our patients.