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Subcostal two-dimensional echocardiographic imaging of peripheral right coronary artery in Kawasaki disease
Insights
A novel echocardiographic method effectively detects right coronary artery aneurysms in Kawasaki disease patients. This technique visualizes aneurysms using a subcostal approach, aiding early diagnosis and management.
Area of Science:
- Pediatric Cardiology
- Diagnostic Imaging
- Rheumatology
Background:
- Kawasaki disease is a leading cause of acquired heart disease in children.
- Coronary artery aneurysms are a serious complication, particularly affecting the right coronary artery.
- Accurate and early detection of these aneurysms is crucial for timely intervention.
Purpose of the Study:
- To introduce and evaluate a new two-dimensional echocardiographic technique for detecting peripheral right coronary aneurysms.
- To assess the efficacy of the subcostal echocardiographic approach in visualizing these aneurysms.
- To compare echocardiographic findings with angiographic results.
Main Methods:
- A specific two-dimensional echocardiographic technique using a subcostal approach was developed.
- The technique focused on examining regions along the tricuspid valve ring and posterior interventricular groove.
- Echocardiographic findings were correlated with angiographic data in patients with Kawasaki disease.
Main Results:
- The new echocardiographic technique successfully visualized 14 right coronary aneurysms in 8 out of 52 Kawasaki disease patients.
- Aneurysms appeared as circular or oval echo-free spaces near the right ventricle or tricuspid valve ring.
- Echocardiographic features correlated well with angiographic findings in size, shape, and location.
- The subcostal approach did not visualize normal coronary arteries, and negative echocardiograms were confirmed by angiography.
Conclusions:
- The developed subcostal echocardiographic technique is a valuable, non-invasive tool for detecting peripheral right coronary aneurysms in Kawasaki disease.
- This method offers a reliable alternative for screening and diagnosis, complementing traditional angiography.
- Early identification of coronary artery aneurysms facilitates prompt management and improves patient outcomes.
Abstract:
A new two-dimensional echocardiographic technique was developed to detect peripheral right coronary aneurysms in Kawasaki disease. Because the main stem of the right coronary artery runs along the tricuspid valve ring and the posterior interventricular groove, these regions were examined for coronary aneurysms using the subcostal approach. Of 52 patients with Kawasaki disease, 14 right coronary aneurysms were visualized in eight patients. Most of the coronary aneurysms were elicited as circular or oval echo-free spaces on the right side of the right ventricle or at the area around the tricuspid valve ring. These echocardiographic features coincided well in size, shape and anatomic position with angiographic appearances. The subcostal approach could not image the normal coronary artery. In three patients whose echocardiograms showed no abnormal echo-free space, the angiographic studies proved that the right coronary arteries were intact. These results suggest that this echocardiographic technique is useful for detecting peripheral right coronary aneurysms in patients with Kawasaki disease.