Importance of evaluation of the right coronary artery by two-dimensional echocardiography in patients after Kawasaki disease: a right parasternal approach

We report the importance of evaluating the right coronary artery (RCA) by two-dimensional echocardiography (2DE) in the acute phase of Kawasaki disease (KD), based on our experience with three patients whose coronary artery lesions (CAL) involving the RCA were missed in the acute phase of KD. Two patients had asymptomatic occlusion of the RCA, and it was speculated that one patient had a cardiac arrest due to CAL of the RCA. An abnormal Q wave in lead III in all 3 patients had indicated stenotic lesions of the RCA. Because it is difficult to diagnose CAL by 2DE in the late period, it is essential to identify the proximal RCA using a right parasternal approach while the patient is lying in the right lateral position.