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Electorcardiographic, M-mode and Two Dimensional Echocardiographic Findings in Kawasaki Syndrome.

Journal of the Korean Pediatric Society 1986;29(11):1201-1214.
Published online November 30, 1986.
Electorcardiographic, M-mode and Two Dimensional Echocardiographic Findings in Kawasaki Syndrome.
In Hwa Lee, Byoung Soo Cho, Sung Ho Cha, Chang Il Ahn
Department of Pediatrics, College of Medicine, Kywng Hee University,Seoul, Korea
Kawasaki증후군에 있어서의 심전도 및 심에코도 소견
이인화, 조병수, 차성호, 안창일
경희대학교 의과대학 소아과학교실
Abstract
This study was undertaken to evaluate the significance of the electrocardiography, M-mode and two dimensional echocardiography and to determine the extent of cardiac involvement in Kawasaki syndrome. The studies of laboratory tests, chest X-ray, electrocardiography, M-mode and two dimensional echocardiography were carried out in 30 subjects with Kawasaki syndrome admitted at K.H.U.H. from 1 st Jan. 1984 to 31th Mar. 1985. The results were as follows; 1) The male to female incidence ratio was 1.5:1. In age distribution, the age group of below 4 years old showed 90% and the most prevalent age group was from 1 to 2 years old showing 36.7%. The mean age was 1.92±1.24(M±SD) years old. 2) The duration of fever was below 10 days in 36.6% before admission and below 7 days in 90% after admission. 3) The platelet counts were below 400,000/mms in 60% on admission, 401,000 〜 500,000/ mm3 in 43.3% on third hospital days, 501,000~600,000/mm8 in 43.3% on 7th hospital days and 401,000〜 500,000/mm3 in 46.7% on 10th hospital days. Thus, the peak platelet counts were shown on 7th hospital days. 4) The heart murmur was audible only in 1 patient (3.3%) and cardiac enlargement was not observed by chest X-ray. 5) The incidence of electrocardiographic abnormalities was 70% among total patients, who had one or more abnormalities. These electrocardiographic abnormalities consisted of prolongation of the Q-Tc interval in 33%, prolongation of the P-R interval in 30%, low amplitude R wave in lead V1 or V6 in 30%, ST-T wave changes in 27%. 6) The incidence of M-mode echocardiographic abnormalities was 30% among total patients, who had one or more abnormalities. These、M-mode echocardiographic abnormalities conisted of increase in ratio of the left posterior wall to septal excursion in 30%, decrease of shortening fraction in 20%, increase of systolic time interval in 17%. But there was no pericardial effusion. 7) The incidence of coronary aneurysms in two dimensional echocardiography was 4 out of 30(13.3%). 8) Among patients with an abnormal M-mode echocardiogram, prolongation of the P-R interval is in 45.5%, prolongation of the Q-Tc interval in 36.4% and low amplitude T wave in lead V5 or V6 in 27.3% by electrocardiograpy. 9) All patients with coronary aneurysms in two dimensional echocardiography had prolongation of the P-R interval and Q-Tc interval on electrocardiography and had increase in ratio of the left posterior wall to septal excursion and decrease of shortening fraction on M-mode echocardiography. 10) Therefore, non-invasive two dimensional echocardiography should be done in all patients especially who had electrocardiographic and M-mode echocardiographic abnormalities to diagnose and follow up the most serious complication, coronary aneurysm
Key Words: Kawasaki syndrome, EKG, M-mode and two dimensional echocardiography


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