Can an ECHO be used to make a diagnosis of Kawasaki Disease?
Recent data suggest that 80% of children with KD who ultimately develop coronary artery lesions (Z-score ≥2 to <2.5=dilation; Z-score ≥2.5=aneurysm) will have them present at the time of diagnosis. Therefore, an ECHO showing coronary artery lesions would be useful in establishing the diagnosis of KD. In general, an abnormal ECHO can be used to establish the diagnosis of KD, but a normal ECHO cannot be used to rule out a diagnosis of KD. A Z-score of >2.5 in the left anterior descending or right coronary artery has a very high specificity for the diagnosis of KD but lacks sensitivity. Similarly, without a Z-score of >2.5, an ECHO is also considered positive for a diagnosis of KD if three or more of the following are met: Z-score of the left anterior descending or right coronary artery of 2 to 2.5; decreased left ventricular function; mitral regurgitation; or pericardial effusion.
