Abstract 16550: Coronary Artery Lack of Tapering and Perivascular Brightness are Unreliable Parameters for Diagnosis of Incomplete Kawasaki Disease

Introduction: In 2004 the AHA endorsed an algorithm for the evaluation of suspected incomplete Kawasaki disease (iKD) relying on echocardiogram (echo) for diagnosis. Echo is positive if coronary artery (CA) Z scores are ≥2.5; CA meet criteria for aneurysm; or ≥3 of the following findings are present: lack of tapering (LT), perivascular brightness (PB), decreased left ventricular function, mitral regurgitation, pericardial effusion, CA Z score 2-2.49. The utility of PB and LT as diagnostic parameters are unvalidated. Hypothesis: LT and PB are unreliable, subjective findings, seen in systemic febrile illnesses without KD and in normal controls. Methods: Single center retrospective study from 1/08-1/17. Based on preliminary data, 100 subjects were used to assess reliability. De-identified diagnostic echo clips of CA from patients ages 0-10 years were interpreted blindly by 6 pediatric cardiologists specializing in imaging. Patients were grouped as follows: 1) KD: IVIG treatment, 4-5 clinical criteria at pres...