Peds cardio

Question 1

an acute, self-limited, multi-systemic vasculitis of unknown origin.
leading cause of acquired heart disease in children

Answer 1

Kawasaki Disease

Question 2

Kawasaki disease diagnostic criteria

Answer 2

high and spiking fever for at 5 days and at least 4 other symptoms such as: bilateral nonexudative bulbar conjunctivitis
Red, edematous cracked lips, strawberry tongue; pharyngeal erythema
Polymorphous exanthem with perineal accentuation
Palmar and solar erythema with tender induration of hands and feet and desquamation 1-3 weeks after onset
Anterior cervical adenopathy (one or more nodes with diameter larger then 1.5cm)

Question 3

Kawasaki disease clinical presentation

Answer 3

Irritability
Headache
Vomiting
Abdominal pain
Diarrhea
Urethritis
Arthralgia and arthritis
Rarely hearing loss or testicular swelling may occur

Question 4

Lab Test to consider for kawasaki disease

Answer 4

Elevated acute phase reactants are seen so ESR, CRP, platelet
Thrombocytosis peaks at 10-14 days
Abnormal lipid metabolism may be evident for some time

Question 5

imaging studies for Kawasaki disease

Answer 5

echocardiogram to evaluate for coronary artery dilatation.

Question 6

Kawasaki treatment

Answer 6

IVIG therapy that can be repeated x1
Possible IV methylprednisolone
High dose of aspirin at 80-100mg per kg until afebrile
Aspirin at 3-5mg/kg/day for at least 8 weeks
Cardiology referral
Follow up echo as determined by cardiology
Other interventions if coronary artery abnormalities are found
Trying to start treatment before 10 days of symptoms

Question 7

The cardiovascular history should include

Answer 7

notations regarding
gestation, family history, neonatal status, growth and development, and feeding patterns
for infants. For older children, the history should include the presence of palpitations, chest
pain, lightheadedness or syncope, and activity level, remembering that the range of activity
in healthy children is great and that children who have congenital heart defects generally
have not experienced a decline in their exercise tolerance. Positive findings in any of these
areas should increase suspicion that a murmur might be pathologic.