Peds Cardiac

Question 1

What is the diagnostic criteria for Kawasakis disease?

Answer 1

Physical Findings
1. Diagnostic criteria includes presence of:

a. Fever (typically high 􏰁 39°C/102°F) for at least 5 days AND four of the five following clinical features:
b. Bilateral, painless conjunctival injection without exudate (pink eye without pus)
c. Inflammatory changes of lips and oral cavity— erythema, dryness and cracking of lips, strawberry tongue
d. Changes to extremities—acute erythema and/or edema of hands/feet, desquamation (skin peeling) with advanced stage
e. Polymorphous macular rash urticarial or pruritic
f. Cervical nonfluctuant lymphadenopathy; at least one lymph node more than 1.5 cm in diameter; usually unilateral (least common symptom)

Question 2

What lab tests needs to be done for Kawasaki’s disease? Select:

1. CBC
2. ESR
3. CRP
4. ALT/AST
5. UA
6. Throat culture
7. Echocardiogram

Answer 2

All of it
Throat culture to rule out strep
Echocardiogram ( coronary aneurysm)
The arteries in your child’s heart can become inflamed causing a coronary artery aneurysm. This is when a main blood vessel supplying blood to the heart muscle becomes damaged and swells because the artery wall is weakened by inflammation. This creates a balloon-like bulge in the artery which can burst and be fatal. Damage to the vessel can also increase the risk of a clot forming. A severe clot can stop blood flow to the heart muscle and cause a heart attack.

Question 3

What is the management of Kawasaki?

Answer 3

Immediate referral
High dose of aspirin to reduce inflammation. usually infants not given aspirin due to Reyes syndrome
Refer for IV immune globulin and aspirin.

Question 4

What ECG changes do you see in kawasaki?

Answer 4

Prolonged PR or QT interval.

Question 5

What does TORCH stand for and what risk does it pose when the mother has TORCH?

Answer 5

Toxoplasmosis
Other (syphillis, coxsackie)
Rubella
CMV
Herpes
It can cause congenital heart disease.