KD Forum

My 13 year old daughter was treated for KD April 6, 2007. The echo done on April 6 and on May 17 both showed no irregularities. Her infectious disease doctor said no further echos are needed. My question is this; Is there a chance of any KD heart related problems forming after the May 17 echo? Since she is only the second teen the infectious disease doctor has ever treated, I'd like another opinion. Thanks!

Marti

FROM DR. ANNE ROWLEY:

In Kawasaki Disease, effects on the heart occur within weeks after the onset of fever. Coronary artery abnormalities develop in children (and teens) with Kawasaki Disease within the first 6-8 weeks after the onset of fever. The last echo at the 6-8 week mark should be performed at a time that the sedimentation rate has returned to normal. If the ESR (sedimentation rate) and the echo are normal at 6-8 weeks after the onset of fever, we discontinue aspirin and consider the child to have escaped coronary artery disease from Kawasaki Disease. Although many centers still do an echocardiogram at one year after the onset, there is no real evidence that coronary disease would be detected at one year but not at 6-8 weeks.

machorse wrote:My 13 year old daughter was treated for KD April 6, 2007. The echo done on April 6 and on May 17 both showed no irregularities. Her infectious disease doctor said no further echos are needed. My question is this; Is there a chance of any KD heart related problems forming after the May 17 echo? Since she is only the second teen the infectious disease doctor has ever treated, I'd like another opinion. Thanks!

Marti

Reply

Assuming that your daughter came down with fever sometime in late March or early April, further assuming that her symptoms were all gone and her appetite and energy level went back to normal by the time she had her second echo on May 17 (about 6-7 weeks from disease onset)and further assuming that quality of the echo study was "diagnostic" (meaning the cardiologist could see all major segments of cornary arteries), there is little to gain from repeating more echos at considerable cost (no matter who ends up paying). The evidence is convincing that once echo done at the end of convalescent period is normal, it will stay normal. If you still have doubts in your mind, I would suggest asking the cardiology lab to make a copy of the echo available (either on CD or videotape) and have it reviewed by another cardiologist to verify that all was normal. Hope this helps.

M Takahashi, MD