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The Importance of Echocardiogram during the Second Week of Illness in Children with Kawasaki Disease.
Ma, Shani; Choi, So Yung; Ahn, Hyeong Jun; Siu, Andrea M; Melish, Marian E; Bratincsak, Andras.
Afiliação
  • Ma S; John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI.
  • Choi SY; Biostatistics Core, Department of Complimentary and Integrative Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI.
  • Ahn HJ; Biostatistics Core, Department of Complimentary and Integrative Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI.
  • Siu AM; Hawai'i Pacific Health Research Institute, Hawai'i Pacific Health, Honolulu, HI.
  • Melish ME; Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI; Kapi'olani Medical Specialists, Hawai'i Pacific Health, Honolulu, HI.
  • Bratincsak A; Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI; Kapi'olani Medical Specialists, Hawai'i Pacific Health, Honolulu, HI. Electronic address: ibrati@me.com.
J Pediatr ; 218: 72-77.e1, 2020 03.
Article em En | MEDLINE | ID: mdl-31810628
OBJECTIVE: To determine the timing of peak coronary artery dilation and the characteristics of patients who present with new-onset coronary artery dilation during the acute phase of Kawasaki disease with an initial normal echocardiogram. STUDY DESIGN: This retrospective study analyzed 231 children hospitalized for Kawasaki disease in Hawai'i over a period of 7 years. Clinical and echocardiographic data were collected to calculate the timing of peak z score, and study subjects were compared based on the timing of coronary dilation. RESULTS: Peak coronary artery dilation was observed on average at 11.5 days from the onset of fever (median 8, IQR 7-13 days). Among study subjects with normal z scores in both coronary arteries during the initial encounter and echocardiogram (n = 164), 16 (10%) developed coronary artery dilation or aneurysm at the second echocardiogram, and 5 (3%) continued to have coronary artery dilation or aneurysm at the convalescent phase. CONCLUSIONS: A repeat echocardiogram during the second week of illness (day 7-14 from fever onset) in patients with normal initial echocardiogram could identify new-onset coronary artery dilation or aneurysm and could be useful in the timely adjustment of antithrombotic or anti-inflammatory therapies.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Aneurisma Coronário / Ecocardiografia / Vasos Coronários / Síndrome de Linfonodos Mucocutâneos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2020 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Aneurisma Coronário / Ecocardiografia / Vasos Coronários / Síndrome de Linfonodos Mucocutâneos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2020 Tipo de documento: Article País de publicação: Estados Unidos