Follow-Up Method in Patients with Kawasaki Disease who had No Coronary Artery Abnormalities in the Convalescent Period / 소아과

ABSTRACT

PURPOSE: We performed the study to evaluate the value of the follow-up echocardiogram performed 6 months to 1 year after the onset of Kawasaki disease(KD), as recommended by American Heart Association(AHA) guidelines, when echocardiograms in the convalescent period were normal. METHODS: Patients were selected from 147 cases diagnosed with KD at Pusan Paik hospital from January 2000 to October 2003. A total of 45 KD patients belonged to AHA risk level I and II were performed follow-up echocardiography. The patient's medical records and echocardiogram were reviewed. Additionally, we sought the opinion of pediatric cardiologists on the subject by means of a multiple-choice survey. RESULTS: 37 children were belonged to AHA risk level I and the remaining 8 patients were belonged to risk level II. Of these 45 children, none were noted to have abnormalities on later follow-up echocardiogram. In the results of questionnaire, 37 percent of the participants advocate no follow-up after convalescent period for risk level I, and 33.3 percent favor periodic follow-up with echocardiography for risk level II up to one year. But there were no consensus about the diagnostic criteria of coronary abnormalities and how to follow-up these patients. CONCLUSION: All children with KD should have an echocardiogram at present and a follow-up study 6 to 8 weeks after the onset of fever. However, additional echocardiographies are not justified if the 6- to 8-week follow-up echocardiogram is normal. We would recommend that the more reasonable diagnostic criteria for coronary abnormalities and the Korean guidelines for long-term cardiovascular management and follow-up of KD need to be established.