Two-dimensional echocardiographic visualization of the peripheral right coronary artery in patients with mucocutaneous lymph node syndrome.

New two-dimensional echocardiographic techniques to visualize the proximal, mid and distal portions of the right coronary artery (RCA) and posterior descending artery were described in patients with mucocutaneous lymph node syndrome (MCLS). The proximal portion of the RCA was imaged by modified apical approach, and its length was longer than that by the conventional parasternal method. This artery was detected in all patients. The mid portion of the RCA was detected by directing the transducer to the right from parasternal window. Adequate visualization of this portion was obtained in 78 percent of patients. To image the distal portion of the RCA, the transducer was directed inferiorly from the parasternal four-chamber view. Adequate imaging of this portion was possible in all. The posterior descending artery was examined by tilting the transducer inferiorly after obtaining the parasternal long-axis view. In 56 percent of patients, a sufficient echogram was not obtained. Validity of these methods was confirmed by reasonable agreement between two-dimensional echocardiographic and coronary angiographic findings. Using these approaches, no peripheral aneurysm was missed by two-dimensional echocardiography. New approaches are useful in evaluating the RCA in patients with MCLS, and are also recommended to evaluate the RCA in other disorders.