All issues > Volume 29(11); 1986

Original Article

J Korean Pediatr Soc. 1986;29(11):1201-1214. Published online November 30, 1986.

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

In Hwa Lee¹, Byoung Soo Cho¹, Sung Ho Cha¹, Chang Il Ahn¹

¹Department of Pediatrics, College of Medicine, Kywng Hee University，Seoul, Korea

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

Keywords :Kawasaki syndrome; EKG; M-mode and two dimensional echocardiography