The Role of Early Echocardiography in Low-Risk Patients With Kawasaki Disease
William D Renton1,2,3, Jake Carmody4, Emma Mactaggart4
1Rheumatology Service, Department of General Medicine, The Royal Children's Hospital, Melbourne, Australia.
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Summary
Early echocardiograms in Kawasaki disease (KD) impact management, even in low-risk patients. Baseline echocardiography is recommended for all KD cases to guide treatment decisions and improve outcomes.
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.