Kawasaki Disease (KD) is the leading cause of acquired heart disease among children in the developed world. Consensus-based guidelines from the American Heart Association (AHA) recommend echocardiograms be performed at the time of diagnosis, at two weeks, and again at 4-6 weeks for uncomplicated KD. This study examines the frequency of cardiac abnormalities on follow-up echocardiograms in patients with uncomplicated KD. We performed a retrospective chart review using the electronic health record at a tertiary care freestanding children's hospital, non-KD referral center. Patients with KD hospitalized from 1/1/2005 to 10/31/2016 were screened for uncomplicated disease (defined as normal echocardiogram upon diagnosis and fever resolution with initial therapy). Ninety-four patients with uncomplicated KD were included in this study. Fifty-seven percent were male, and the median age was 2.6 years (range=0.15-12). Fifty patients had an echocardiogram performed at two weeks, revealing no (0%) coronary abnormalities. Fifty-six patients had an echocardiogram performed at 6-8 weeks, revealing no coronary anomalies (0%). This study revealed that patients with uncomplicated KD did not develop coronary abnormalities on follow-up echocardiograms, providing additional evidence to help inform current KD guidelines. Further studies are needed to evaluate the optimal frequency of recommended echocardiograms for patients with uncomplicated KD.
| Published in | Science Journal of Clinical Medicine (Volume 10, Issue 4) |
| DOI | 10.11648/j.sjcm.20211004.13 |
| Page(s) | 97-101 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2021. Published by Science Publishing Group |
Kawasaki Disease, Echocardiography, Pediatric Cardiology, Hospital Medicine
| [1] | Dajani AS, Taubert KA, Takahashi M, Bierman FZ, Freed MD, Ferrieri P, Gerber M, Shulman ST, Karchmer AW, Wilson W. Guidelines for long-term management of patients with Kawasaki disease. Report from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 1994 Feb; 89 (2): 916-22. |
| [2] | Belay ED, Maddox RA, Holman RC, Curns AT, Ballah K, Schonberger LB. Kawasaki syndrome and risk factors for coronary artery abnormalities: United States, 1994 –2003. Pediatr Infect Dis J. 2006; 25: 245–249. |
| [3] | Freeman AF, Shulman ST. Kawasaki disease: summary of the American Heart Association guidelines. Am Fam Physician. 2006; 74 (7): 1141–8. |
| [4] | Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, Shulman ST, Bolger AF, Ferrieri P, Baltimore RS, Wilson WR, Baddour LM, Levison ME, Pallasch TJ, Falace DA, Taubert KA. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2004; 110: 2747–2771. |
| [5] | Lee MH, Dai ZK, Lee MS, Hsu JH, Chuang HY, Wu JR. The recommended frequency of echocardiography in follow-up evaluation of patients with Kawasaki disease. Acta Paediatr Taiwan. 2005; 46: 346–351. |
| [6] | McCrindle BW, Rowley AH, Newburger JW, et al; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; and Council on Epidemiology and Prevention. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017; 135 (17): e927-e999. |
| [7] | Dominguez SR, Anderson MS, El-Adawy M, Glodé MP. Preventing coronary artery abnormalities: a need for earlier diagnosis and treatment of Kawasaki disease. Pediatr Infect Dis J. 2012; 31: 1217–1220. |
| [8] | Scott JS, Ettedgui JA, Neches WH. Cost-effective use of echocardiography in children with Kawasaki disease. Pediatrics. 1999; 104: e57. |
| [9] | de Ferranti SD, Gauvreau KK, Berry E, Tang A, Baker A, Fulton D, Friedman K, Tremoulet A, Burns JC, Newburger JW. Association of initially normal coronary arteries with normal findings on follow-up echocardiography in patients with Kawasaki disease. JAMA Pediatr. 2018; 172 (12): e183310. |
| [10] | Choosing Wisely. (2017) Echocardiograms for heart valve disease: When you need the test-and when you don't. http://www.choosingwisely.org/patientresources/echocardiograms-for-heart-valve-disease/ |
| [11] | Tuohy AM, Tani LY, Cetta F, Lewin MB, Eidem BW, Van Buren P, Williams RV, Shaddy RE, Touhy RP, Minich LL. How many echocardiograms are necessary for follow up evaluation of patients with Kawasaki disease? The American Journal of Cardiology. 2001; 88: 328-330. |
| [12] | Lowry, AW, Knudson JD, Myones BL, Moodie DS, Han Ys. Variability in delivery of care and echocardiogram surveillance of Kawasaki disease. Congenital Heart Disease. 2012; 7: 336-343. Pivovarenko Y. (2020) Negative Electrization of the Sargasso Sea as the Cause of Its Anomaly. American Journal of Electromagnetics and Applications, 8 (2), 33-39. |
| [13] | Gordon JB, Kahn AM, Burns JC. When children with Kawasaki disease grow up: Myocardial and vascular complications in adulthood. J Am Coll Cardiol. 2009 Nov 17; 54 (21): 1911-20. doi: 10.1016/j.jacc.2009.04.102. PMID: 19909870; PMCID: PMC2870533. |
| [14] | Lin MT, Sun LC, Wu ET, Wang JK, Lue HC, Wu MH. Acute and late coronary outcomes in 1073 patients with Kawasaki disease with and without intravenous γ-immunoglobulin therapy. Arch Dis Child. 2015 Jun; 100 (6): 542-7. doi: 10.1136/archdischild-2014-306427. Epub 2015 Jan 6. PMID: 25564534. |
| [15] | Oates-Whitehead RM, Baumer JH, Haines L, et al. Intravenous immunoglobulin for the treatment of Kawasaki disease in children. Cochrane Database Syst Rev. 2003; 2003 (4): CD004000. doi: 10.1002/14651858.CD004000. |
APA Style
Shaila Siraj, Carlos Sanchez Parra, Jasmine Jordan, Ashish Shah, Ernest Amankwah, et al. (2021). Clinical Utility of Follow-up Echocardiograms in Uncomplicated Kawasaki Disease. Science Journal of Clinical Medicine, 10(4), 97-101. https://doi.org/10.11648/j.sjcm.20211004.13
ACS Style
Shaila Siraj; Carlos Sanchez Parra; Jasmine Jordan; Ashish Shah; Ernest Amankwah, et al. Clinical Utility of Follow-up Echocardiograms in Uncomplicated Kawasaki Disease. Sci. J. Clin. Med. 2021, 10(4), 97-101. doi: 10.11648/j.sjcm.20211004.13
AMA Style
Shaila Siraj, Carlos Sanchez Parra, Jasmine Jordan, Ashish Shah, Ernest Amankwah, et al. Clinical Utility of Follow-up Echocardiograms in Uncomplicated Kawasaki Disease. Sci J Clin Med. 2021;10(4):97-101. doi: 10.11648/j.sjcm.20211004.13
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.sjcm.20211004.13,
author = {Shaila Siraj and Carlos Sanchez Parra and Jasmine Jordan and Ashish Shah and Ernest Amankwah and Jeffrey Fadrowski},
title = {Clinical Utility of Follow-up Echocardiograms in Uncomplicated Kawasaki Disease},
journal = {Science Journal of Clinical Medicine},
volume = {10},
number = {4},
pages = {97-101},
doi = {10.11648/j.sjcm.20211004.13},
url = {https://doi.org/10.11648/j.sjcm.20211004.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20211004.13},
abstract = {Kawasaki Disease (KD) is the leading cause of acquired heart disease among children in the developed world. Consensus-based guidelines from the American Heart Association (AHA) recommend echocardiograms be performed at the time of diagnosis, at two weeks, and again at 4-6 weeks for uncomplicated KD. This study examines the frequency of cardiac abnormalities on follow-up echocardiograms in patients with uncomplicated KD. We performed a retrospective chart review using the electronic health record at a tertiary care freestanding children's hospital, non-KD referral center. Patients with KD hospitalized from 1/1/2005 to 10/31/2016 were screened for uncomplicated disease (defined as normal echocardiogram upon diagnosis and fever resolution with initial therapy). Ninety-four patients with uncomplicated KD were included in this study. Fifty-seven percent were male, and the median age was 2.6 years (range=0.15-12). Fifty patients had an echocardiogram performed at two weeks, revealing no (0%) coronary abnormalities. Fifty-six patients had an echocardiogram performed at 6-8 weeks, revealing no coronary anomalies (0%). This study revealed that patients with uncomplicated KD did not develop coronary abnormalities on follow-up echocardiograms, providing additional evidence to help inform current KD guidelines. Further studies are needed to evaluate the optimal frequency of recommended echocardiograms for patients with uncomplicated KD.},
year = {2021}
}
TY - JOUR T1 - Clinical Utility of Follow-up Echocardiograms in Uncomplicated Kawasaki Disease AU - Shaila Siraj AU - Carlos Sanchez Parra AU - Jasmine Jordan AU - Ashish Shah AU - Ernest Amankwah AU - Jeffrey Fadrowski Y1 - 2021/11/05 PY - 2021 N1 - https://doi.org/10.11648/j.sjcm.20211004.13 DO - 10.11648/j.sjcm.20211004.13 T2 - Science Journal of Clinical Medicine JF - Science Journal of Clinical Medicine JO - Science Journal of Clinical Medicine SP - 97 EP - 101 PB - Science Publishing Group SN - 2327-2732 UR - https://doi.org/10.11648/j.sjcm.20211004.13 AB - Kawasaki Disease (KD) is the leading cause of acquired heart disease among children in the developed world. Consensus-based guidelines from the American Heart Association (AHA) recommend echocardiograms be performed at the time of diagnosis, at two weeks, and again at 4-6 weeks for uncomplicated KD. This study examines the frequency of cardiac abnormalities on follow-up echocardiograms in patients with uncomplicated KD. We performed a retrospective chart review using the electronic health record at a tertiary care freestanding children's hospital, non-KD referral center. Patients with KD hospitalized from 1/1/2005 to 10/31/2016 were screened for uncomplicated disease (defined as normal echocardiogram upon diagnosis and fever resolution with initial therapy). Ninety-four patients with uncomplicated KD were included in this study. Fifty-seven percent were male, and the median age was 2.6 years (range=0.15-12). Fifty patients had an echocardiogram performed at two weeks, revealing no (0%) coronary abnormalities. Fifty-six patients had an echocardiogram performed at 6-8 weeks, revealing no coronary anomalies (0%). This study revealed that patients with uncomplicated KD did not develop coronary abnormalities on follow-up echocardiograms, providing additional evidence to help inform current KD guidelines. Further studies are needed to evaluate the optimal frequency of recommended echocardiograms for patients with uncomplicated KD. VL - 10 IS - 4 ER -
Email: