Kawasaki disease: echocardiographic features in 91 cases presenting in the United Kingdom

Area of Science:

• Pediatric Cardiology
• Rheumatology
• Diagnostic Imaging

Background:

• Kawasaki disease is a leading cause of acquired heart disease in children.
• Coronary artery abnormalities are a significant complication, potentially leading to long-term cardiovascular issues.

Purpose of the Study:

• To evaluate the prevalence and persistence of coronary arterial lesions in patients with Kawasaki disease.
• To assess the long-term implications of these lesions and identify patients requiring ongoing surveillance.

Main Methods:

• Cross-sectional echocardiography was performed on 91 patients diagnosed with Kawasaki disease between 1980 and 1988.
• Echocardiograms were conducted during the acute phase (within one month) and in a follow-up group (one month to four years post-illness).

Main Results:

• Coronary arterial lesions were identified in 28% of patients during the acute phase.
• Lesions persisted in 23% of patients, particularly younger children, with two cases of myocardial infarction and one death.
• No coronary abnormalities were found in patients examined after one month.

Conclusions:

• Early echocardiography is crucial for detecting coronary arterial lesions in Kawasaki disease.
• Persistent lesions necessitate long-term monitoring, including echocardiography and exercise electrocardiography, due to potential progression and stenosis.
• Further investigation, potentially including coronary arteriography, may be indicated for select cases.