The Role of Early Echocardiography in Low-Risk Patients With Kawasaki Disease

Area of Science:

• Pediatric Cardiology
• Rheumatology
• Diagnostic Imaging

Background:

• Kawasaki disease (KD) can lead to coronary artery aneurysms (CAA).
• There's debate on the utility of early echocardiograms in low-risk KD patients.
• Current practice sometimes delays echocardiography based on perceived low risk of CAA.

Purpose of the Study:

• To assess how often early echocardiography results alter management in KD patients.
• To specifically evaluate the impact on low-risk patients for medium-giant aneurysms.
• To inform guidelines on baseline echocardiography in KD.

Main Methods:

• Retrospective chart review at a pediatric tertiary referral center.
• Data collected: demographics, echocardiography results, treatments.
• Risk stratification based on prospectively defined criteria.

Main Results:

• 147 KD patients included; 8.8% had aneurysms on baseline echo.
• 4.7% of 'low-risk' and 14.7% of 'high-risk' patients had aneurysms.
• Management changed in 3 'low-risk' and 7 'high-risk' patients.

Conclusions:

• Baseline echocardiography is valuable for all KD patients, irrespective of initial risk assessment.
• Echocardiography findings can lead to treatment intensification and adjustments.
• Further research is needed for improved KD risk stratification.