Cardiac Involvement and Risk Factors in Kawasaki Disease

Background& Objective: Kawasaki disease is a generalized vasculitis of unknown etiology which causes coronary artery abnormalities in 20-25 percent of untreated children. The aim of this study was to determine the type of heart lesion and the coronary risk factors and to identify patients with high risk in order to take the necessary measures to reduces morbidity and morbidity. Materials & Methods: We studied 70 children, aged 3 month to 10 years, who met the criteria for the diagnosis of KD, two thirds were males. Results: Of the (70) children who had KD , 15 cases (21.4 %) had coronary artery abnormalities ,12 cases (17 %) had pericarditis, and 7 cases (10 %) had mitral regurgitation .The coronary artery abnormalities were classified as follows: diffuse ectasia (5) cases 33.3%, coronary artery aneurysms 10 cases (66.6%). small to medium-sized coronary artery aneurysms (6) cases, large sized coronary artery aneurysms (2) cases, and giant aneurysms in (2) cases . The risk factors for coronary aneurysms were age less than 1 year or more than 5 years, male gender, fever lasting more than 10 days or recurrence of fever after an a febrile period, lower hemoglobin, lower platelet count, higher white cell count , lower albumin level and pericarditis. Echocardiogram follow up studied indicate coronary artery aneurysms resolve within 5 to 31 months in approximately 60% of patients where (6) aneurysms regressed spontaneously and the two large aneurysms became smaller. One patient with giant aneurysm had developed coronary stenosis and needed a coronary bypass surgery at the age of 9 years. Conclusion: Coronary aneurysms were the predominant cardiac lesions in our series, most of these aneurysms were resolved at follow up of 2-3 years.

Fetal Echocardiography in Diagnosing Congenital Heart Disease Prenatally

Prenatal detection of congenital heart disease is possible from the 16th week of pregnancy. the ideal time being the Midtrimester ,when the most cardiac abnormalities can be detected ,where all routine cross sectional views are easily obtainable. To evaluate the detection and accuracy of fetal echocardiography for congenital heart defects among high risk pregnancies.