What follow-up testing is required after a diagnosis of Kawasaki disease to assess for complications?

In Kawasaki disease, the major concern is the potential development of coronary artery aneurysms due to inflammation of the blood vessels. Following the diagnosis of Kawasaki disease, an echocardiogram is the most appropriate next step to evaluate for these complications. This imaging study allows clinicians to assess the coronary arteries for any signs of dilation or aneurysm formation, which can occur in up to 25-30% of untreated patients.

While an electrocardiogram (ECG) can be helpful to monitor for arrhythmias, it does not provide direct information about the structural integrity of the coronary arteries. A chest X-ray primarily assesses heart size and does not specifically evaluate coronary artery status. Blood tests can help monitor inflammation but do not provide information about the condition of the coronary vessels themselves. Thus, the echocardiogram is crucial for the immediate follow-up in managing the risks associated with Kawasaki disease.