Two‐Dimensional echocardiographic imaging of distal right coronary artery in kawasaki disease

Kawasaki disease, or mucocutaneous lymph node syndrome, is a common febrile illness affecting young children. It is characterized by fever, lymphadenitis, mucosal and cutaneous inflammation, and vasculitis. It is usually a self-limiting disease. Approximately 15% of Japanese children with Kawasaki disease develop coronary arteritis.' Development of coronary artery aneurysms and thrombosis may result in death in 1% of the cases.' Spontaneous resolution of coronary artery aneurysms has been documented in 50% of the cases.' Attempts have been made to identify children who are at risk of developing coronary artery aneurysms. A scoring table introduced by Asai has not proved useful in many reported case^.^'^ Initially, coronary angiography was felt to be the only definitive way of evaluating the coronary arteries but recently, two-dimensional echocardiography has proved useful in identifying aneurysms of the main right and left coronary Some studies have stressed that aneurysms of the distal right and left coronary arteries cannot be visualized by ech~cardiography.~,~ Yoshida et al. may be the first authors to report visualization of peripheral right coronary artery aneurysms by subcostal two-dimensional echocardiography.' We would like to present our findings in two cases of Kawasaki disease in whom peripheral right coronary artery aneurysms were first diagnosed by two-dimensional echocardiography.