In Kawasaki disease, what test should be ordered to evaluate for cardiac complications?

In Kawasaki disease, what test should be ordered to evaluate for cardiac complications?

• A. EKG
• B. Chest X-ray
• C. 2DE
• D. CT angiography

Answer: (C)

Kawasaki disease can cause coronary artery abnormalities and myocarditis, so imaging that directly visualizes the heart and its vessels is essential. A two-dimensional echocardiogram with Doppler provides the best initial and ongoing assessment of cardiac involvement, including visualization of the coronary arteries for dilation or aneurysm, as well as evaluating ventricular function, valvular regurgitation, and any pericardial effusion. This makes it the most informative, noninvasive test for detecting and tracking cardiac complications. Other options don’t offer the same direct assessment of coronary anatomy or heart structure. An EKG shows electrical activity but not structural changes; a chest X-ray is nonspecific for cardiac complications; CT angiography can image coronaries but involves radiation and contrast and is not first-line for routine evaluation. Baseline echocardiography at diagnosis with serial follow-up is supported by guidelines to monitor for evolving coronary involvement.

Kawasaki disease can cause coronary artery abnormalities and myocarditis, so imaging that directly visualizes the heart and its vessels is essential. A two-dimensional echocardiogram with Doppler provides the best initial and ongoing assessment of cardiac involvement, including visualization of the coronary arteries for dilation or aneurysm, as well as evaluating ventricular function, valvular regurgitation, and any pericardial effusion. This makes it the most informative, noninvasive test for detecting and tracking cardiac complications.

Other options don’t offer the same direct assessment of coronary anatomy or heart structure. An EKG shows electrical activity but not structural changes; a chest X-ray is nonspecific for cardiac complications; CT angiography can image coronaries but involves radiation and contrast and is not first-line for routine evaluation. Baseline echocardiography at diagnosis with serial follow-up is supported by guidelines to monitor for evolving coronary involvement.