How is cardiac status evaluated in the workup of Kawasaki disease?

Updated: Jul 29, 2018
  • Author: Tina K Sosa, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Echocardiography is the study of choice to evaluate for CAAs, in both fully manifested and suspected incomplete cases of KD. Serial echocardiograms should be obtained, preferably at the time of KD diagnosis, at 1-2 weeks, and at 5-6 weeks after the onset of the illness. These may need to be performed more frequently in high-risk patients. [56, 62, 4]

On electrocardiography (ECG), tachycardia, prolonged PR interval, ST-T wave changes, and decreased voltage of R waves may indicate myocarditis. Q waves or ST-T wave changes may indicate MI.

Cardiac enzyme levels (creatine kinase, troponin) are elevated during an MI.

A select group of patients may require cardiac catheterization and angiography. Cardiac angiography provides a more detailed study of the arteries, but it is associated with greater risks of rupture, especially when performed in the acute phase of the illness; it should be limited to select cases. Coronary computed tomography angiography (CTA) and magnetic resonance angiography (MRA) may also prove beneficial in the evaluation and follow-up of the coronary arteries. [63, 64]


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