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Electrocardiographic Changes in Acute Kawasaki Disease in the Era of Immunoglobulin Therapy

Ryo Nakanishi1, Toshiki Nakamura1, Yutaro Koyama2

  • 1Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, Japan, 183-8561.

Pediatric Cardiology
|September 27, 2024
PubMed

Insights

Electrocardiogram (ECG) changes, particularly T wave abnormalities, are common in acute Kawasaki disease (KD). These ECG findings in KD patients treated with IVIG did not correlate with disease severity or treatment outcomes.

Area of Science:

  • Pediatrics
  • Cardiology
  • Rheumatology

Background:

  • Kawasaki disease (KD) is a critical pediatric vasculitis with potential cardiac complications.
  • Electrocardiographic (ECG) changes in acute KD are not well-documented, especially in the context of intravenous immunoglobulin (IVIG) therapy.
  • Understanding ECG patterns and their prognostic implications is crucial for managing KD.

Purpose of the Study:

  • To identify common ECG changes in children with acute Kawasaki disease receiving IVIG.
  • To analyze the temporal course of these ECG abnormalities.
  • To investigate the association between ECG findings and disease severity or treatment response.

Main Methods:

  • A retrospective observational study of 156 pediatric patients diagnosed with KD and treated with IVIG.
  • Analysis of ECGs recorded during the acute phase of illness.
  • Correlation of ECG findings with clinical data, including treatment responsiveness and coronary artery abnormalities.

Main Results:

  • The most frequent ECG abnormalities were T wave changes (90.4%) and T wave inversions (40.4%).
  • Tachycardia (23.1%) and prolonged PR interval (14.7%) were also observed.
  • Less common findings included QTc prolongation and ST changes. Arrhythmias were infrequent.
  • No significant association was found between T wave inversion and disease severity or IVIG unresponsiveness.

Conclusions:

  • T wave changes are highly prevalent in the acute phase of Kawasaki disease.
  • These common ECG findings in KD do not appear to be associated with disease severity or adverse clinical outcomes.
  • Further research is needed to fully elucidate the prognostic value of specific ECG changes in KD.

Keywords:
Coronary artery abnormalitiesElectrocardiogramKawasaki diseaseKobayashi score

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