[Two-dimensional echocardiographic study of coronary artery lesion in Kawasaki disease: a new approach to visualize the right coronary artery].

Recently nonivasive visualization of the left main coronary artery by two-dimensional echocardiography has developed. However, previous reports has described the difficulty to evaluate a right coronary aneurysm and coronary stenosis or obstruction. Therefore two-dimensional echocardiographic studies using 5 MHz linear scanner were performed in 48 patients of Kawasaki disease, and the findings were compared with coronary angiographic findings. Their ages ranged from 3 months to 15 years (mean 3.2 years of age). In coronary angiographic findings, the left main coronary aneurysm was demonstrated in 23 cases, and stenosis of the left coronary artery in 2 cases. While a right coronary aneurysm was demonstrated in 17 cases, and stenosis or obstruction of the right coronary artery in 7 cases. The diagnosis of a coronary aneurysm by linear scanner two-dimensional echocardiography was established in 22 of 23 (96%) patients on the left main coronary artery and in all 17 patients on the right coronary artery. Stenosis or obstruction of the left and right coronary arteries was demonstrated in 1 of 2 (50%) patients and 6 of 7 (86%) patients, respectively. These results were superior to the results of the two-dimensional echocardiographic study by 3.5 mHz sector scanner. The right coronary artery was visualized effectively and extensively by the linear scanner than the sector scanner. We conclude that two-dimensional echocardiography using high frequency linear scanner is a very useful method to diagnose stenotic lesions as well as aneurysmal formation in the right and left coronary arteries and to follow up aneurysms in acute phase and inspect the growth of coronary aneurysms.