Coronary aneurysms in Kawasaki disease: Follow-up observation by two-dimensional echocardiography

Abstract

The development and regression of the coronary aneurysms in Kawasaki disease was studied with serial two-dimensional echocardiographic (2D echo) examinations. The diameter of the aneurysms at the proximal portions of the left coronary artery was measured on the 2D echo images in ten patients with Kawasaki disease, in whom left coronary aneurysms were found at the acute stage of the illness, and followed by 2D echo for longer than eight months. It was found that coronary aneurysms usually developed during the second week of the illness, reached maximal size at 3-8 weeks, and regressed gradually thereafter. Small aneurysms disappeared in several months, and those of intermediate size regressed in one to two years. Large aneurysms may remain for many years. Mural thrombi within the aneurysms were detected with 2D echo in three patients. They decreased in echodensity and eventually disappeared echographically.

Guidelines for Diagnosis and Management of Cardiovascular Sequelae in Kawasaki Disease (JCS 2008) - Digest Version -

“…69, 70 Adults may be diagnosed with Kawasaki disease based on the visualizing of coronary aneurysms. 71 The presence/absence of thrombi within aneurysms can also be determined with echocardiography.…”

Recurrent Kawasaki disease

“…report that coronary artery aneurysms usually develop during the second week of the illness [10] . Aneurysms, if present, reach a maximal size by echocardiography at 3-8 weeks of the illness [10] . In a recent preliminary report, Capannari et al .…”

Guidelines for Diagnosis and Management of Cardiovascular Sequelae in Kawasaki Disease (JCS 2013)

“…100 This technique is useful to follow up coronary dilatation 101, 102 and thrombi in coronary aneurysms. 103 Three-dimensional (3D) echocardiography is useful in visualizing the right coronary artery and the circumflex artery, and in visualizing mural thrombi in coronary aneurysms.…”