In Kawasaki disease, which tests are indicated due to risk of coronary aneurysms?

• A. CT angiography
• B. Echo and ECG
• C. Abdominal ultrasound
• D. MRI brain

Answer: (B)

Kawasaki disease carries a risk of coronary artery aneurysms, so the most important tests are those that directly assess the heart and its vessels. Echocardiography is the first-line, noninvasive way to visualize the coronary arteries for dilation or aneurysm formation and to evaluate heart function and pericardial space. An electrocardiogram complements this by monitoring the heart’s rhythm and detecting any myocarditis or conduction abnormalities that can accompany inflammation.

Other imaging like CT angiography can provide detailed coronary anatomy but is used selectively—typically if the echocardiogram is inconclusive or if precise visualization is needed for planning—and it involves radiation and contrast. Abdominal ultrasound and MRI of the brain don’t address coronary aneurysm risk in Kawasaki disease and are not routinely indicated for this purpose.

So, monitoring with echocardiography and an ECG best addresses the concern for coronary involvement in Kawasaki disease.