What are the echocardiography findings 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

Diffuse dilatation of coronary lumina can be observed in 50% of patients by the 10th day of illness. In children, pediatric cardiologists should ideally perform this study, because they are familiar with coronary artery diameter normal values. Coronary artery dimensions must be adjusted for body surface area to accurately identify dilation. A basic rule is that if the internal diameter of a segment is greater than 1.5 times that of an adjacent segment, then dilation probably exists.

The echocardiogram should be repeated at 1-2 weeks and then 5-6 weeks after disease onset; echocardiograms may need to be performed more frequently in high-risk patients. [56, 62, 4] Frequency of subsequent echocardiography and/or additional cardiac imaging is dependent on the disease severity and the expert opinion of pediatric cardiologists.

In a study that examined echocardiograms obtained at diagnosis and 1 and 5 weeks after diagnosis from 198 patients, Printz et al concluded that non-coronary cardiac abnormalities were associated with coronary artery dilation and laboratory evidence of inflammation within the first 5 weeks after the diagnosis of KD. Left ventricular systolic dysfunction was noted in 20% of patients and coronary artery dilation in 29%. Mitral regurgitation was present in 27% of patients and aortic root dilation in 8%. [67]


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