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Clinical Utility of Follow-up Echocardiograms in Uncomplicated Kawasaki Disease

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.