Sensitivity, specificity and predictive value of two-dimensional echocardiography in detecting coronary artery aneurysms in patients with Kawasaki disease

Seventy-seven patients with Kawasaki disease were prospectively evaluated from 1978 to 1983 to determine the sensitivity, specificity and predictive value for detecting coronary artery aneurysms with two-dimensional echocardiography. Seventy (91%) underwent selective coronary arteriography and are included in this report. The study was divided into two periods because of increased experience and the use of a systematic approach with two-dimensional echocardiography in the second period as compared with the first. Aneurysms were demonstrated in nine patients (13%). The coronary artery system was divided into six regions: proximal third of the main right coronary artery, distal right coronary artery, left main coronary artery, left anterior descending coronary artery, circumflex coronary artery and distal left coronary artery. The sensitivity and specificity were high when imaging the proximal regions, and improved from the first period to the second. Both sensitivity and specificity were lower for the more distal regions of the right and left coronary arteries. Overall, the sensitivity of two-dimensional echocardiography was 100% because there were no patients in our study who had isolated distal coronary artery aneurysms. Two-dimensional echocardiography is a sensitive and specific test for detecting aneurysms in the proximal portions of both the right and left coronary arteries, and is useful in selecting patients for invasive investigation with selective coronary arteriography.

This article has been cited by other articles:

				B. W. McCrindle, J. S. Li, L. L. Minich, S. D. Colan, A. M. Atz, M. Takahashi, V. L. Vetter, W. M. Gersony, P. D. Mitchell, J. W. Newburger, et al. Coronary Artery Involvement in Children With Kawasaki Disease: Risk Factors From Analysis of Serial Normalized Measurements Circulation, July 10, 2007; 116(2): 174 - 179. [Abstract] [Full Text] [PDF]

				M. H. Chamberlain, R. Henry, S. Brann, and G. D. Angelini Surgical management of a gigantic circumflex coronary artery aneurysm with fistulous connection to the coronary sinus Eur. J. Cardiothorac. Surg., December 1, 2001; 20(6): 1255 - 1257. [Abstract] [Full Text] [PDF]

				J. C. Burns, H. I. Kushner, J. F. Bastian, H. Shike, C. Shimizu, T. Matsubara, and C. L. Turner Kawasaki Disease: A Brief History Pediatrics, August 1, 2000; 106(2): 27e - 27. [Abstract] [Full Text]

				S Hiraishi, H Misawa, N Takeda, Y Horiguchi, N Fujino, N Ogawa, and H Hirota Transthoracic ultrasonic visualisation of coronary aneurysm, stenosis, and occlusion in Kawasaki disease Heart, April 1, 2000; 83(4): 400 - 405. [Abstract] [Full Text]

				J. S. Scott, J. A. Ettedgui, and W. H. Neches Cost-Effective Use of Echocardiography in Children With Kawasaki Disease Pediatrics, November 1, 1999; 104(5): 57e - 57. [Abstract] [Full Text]

				J. W Newburger and J. C Burns Kawasaki disease Vascular Medicine, August 1, 1999; 4(3): 187 - 202. [Abstract] [PDF]

				M. D. Cheitlin, J. S. Alpert, W. F. Armstrong, G. P. Aurigemma, G. A. Beller, F. Z. Bierman, T. W. Davidson, J. L. Davis, P. S. Douglas, L. D. Gillam, et al. ACC/AHA Guidelines for the Clinical Application of Echocardiography : A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography) Developed in Collaboration With the American Society of Echocardiography Circulation, March 18, 1997; 95(6): 1686 - 1744. [Full Text]

				E. Pahl, R. Sehgal, D. Chrystof, W. H. Neches, C. L. Webb, C. E. Duffy, S. T. Shulman, and F. A. Chaudhry Feasibility of Exercise Stress Echocardiography for the Follow-up of Children With Coronary Involvement Secondary to Kawasaki Disease Circulation, January 1, 1995; 91(1): 122 - 128. [Abstract] [Full Text]

				W. P. Wright, M. A. Alpert, V. Mukerji, and C. J. Santolin Coronary Artery Aneurysms A Case Study and Literature Review Angiology, August 1, 1991; 42(8): 672 - 679. [Abstract] [PDF]