Cardiovascular abnormalities in Kawasaki disease

Eighteen patients with Kawasaki disease underwent serial, cross sectional echocardiographic examinations to determine the extent and subsequent course of cardiac involvement in this disease. The mean follow up period was 12.3 months. Cardiovascular complications were found in a total of 10 patients (55%). Coronary artery aneurysms were detected in 6 patients (33%), pericardial effusions in two, and one patient had electrocardiographic evidence suggesting inferior myocardial infarction. Coronary artery aneurysms, seen exclusively in infants less than 12 months of age, were found in four to regress over a mean period of 7.5 months (range 1 to 13 months). Electrocardiogram, chest radiographs, and clinical examination were unhelpful in identifying those patients with coronary artery aneurysms. Eight patients (44%) were hypertensive, though only two required treatment. While all patients have survived, serial cross sectional echocardiographs should be performed in children with Kawasaki disease to identify those at risk from potentially fatal complications.