Echocardiographic Evaluation in Kawasaki Disease

Kawasaki disease (KD) is an etiology-unknown but with a generalized inflammatory disorder of multiple organs and systems in childhood. The basic pathologic changes are panvasculitis of the small and medium-sized arteries, mainly the coronary arteries. It is now the leading cause of acquired heart disease during childhood in developed countries and has led to the early development of angina pectoris, myocardial ischemia/infarction, and even sudden cardiac death in early adulthood. Although there is no definitive diagnostic test for KD, the accurate diagnosis is dependent on the clinical presentations to meet the diagnostic criteria. Echocardiography is a well-known noninvasive tool to detect structural abnormalities and evaluation of cardiovascular function. It has been reported to detect accurately the early and late cardiovascular abnormalities, including perivascular brightness, lack of tapering, dilatation, and aneurysmal formation of coronary arteries as well as the mitral/aortic regurgitation, pericardial effusion, and myocardial functional changes in KD. In cases of incomplete form of KD and patients whose clinical manifestations did not meet the diagnostic criteria, abnormal echocardiographic findings of coronary artery may provide the assistance for early diagnosis of KD. Long-term periodic echocardiographic follow-up is the basic and essential study for patients of KD with initial coronary arterial abnormalities. Ninety nine articles that studied echocardiographic findings of KD had been reviewed and will be discussed.