**17. Acknowledgements**

We would like to thank Professor Mike South for his contribution of catheterisation images, and Dr Adam Doyle for the coronary artery illustration.

#### **18. References**

150 Echocardiography – In Specific Diseases

There is evidence that Kawasaki disease in childhood may increase the risk of cardiovascular disease in adulthood. Patients with coronary artery aneurysms have an increase in carotid artery intima-media thickness, and increased systemic arterial stiffness with higher pulse wave velocities (Cheung et al., 2007; Ooyanagi et al., 2004; Suzuki et al., 1996). Furthermore there are data demonstrating abnormal vascular endothelial function

Patients with Kawasaki disease should be followed up based on risk stratification according to the severity of coronary artery involvement in consultation with a paediatric cardiologist

**Kawasaki disease is a common childhood systemic vasculitis characterized by** 

**Transthoracic echocardiography is recommended in suspected cases of Kawasaki** 

 **Treatment with high dose intravenous immunoglobulin should be initiated based on the clinical presentation, and should not be delayed by the timing of** 

 **The aims of echocardiography are to identify coronary artery dilatation and aneurysms, valvar regurgitation, myocarditis with ventricular dysfunction and** 

 **Echocardiography should be performed at diagnosis, and approximately 6-8 weeks after the onset of illness, with more frequent assessments required if cardiac** 

In summary, Kawasaki disease is an important and common systemic vasculitis of childhood, and the advent of intravenous immunoglobulin has significantly reduced, but not removed the risk of abnormal coronary artery development in affected individuals. There have been significant advances in our overall understanding of the condition, although the aetiology remains uncertain. Of concern is the emerging evidence that KD is a risk factor for adult coronary artery disease. Further research into pathogenesis and long

We would like to thank Professor Mike South for his contribution of catheterisation images,

and lipid profiles in patients. The exact level of increased risk is uncertain.

**specific clinical features and persistent fever for at least 5 days.** 

**disease, however a normal study does not exclude the diagnosis.** 

**15. Follow-up recommendations** 

familiar with managing the condition.

**echocardiography.** 

**pericarditis with effusion.** 

**involvement is present.** 

**16. Conclusion** 

term outcomes are required.

**17. Acknowledgements** 

Table 2. Kawasaki disease - Summary points

and Dr Adam Doyle for the coronary artery illustration.


**10** 

*Iran* 

**Cardiac Tumors** 

 *Molla Sadra Avenue, Tehran* 

Maryam Moshkani Farahani

*Department of Echocardiography, Faculty of Medicine,* 

Cardiac tumors are among important group of cardiovascular diseases. Early diagnosis is necessary for the best management of the tumors. There are several imaging modalities available for cardiac tumors for diagnosis including echocardiography (transthoracic echocardiography, transesophageal echocardiography, 3 dimensional echocardiography) magnetic resonance imaging (MRI) and CT scan. However, echocardiography remains the best available noninvasive tool for the diagnosis of cardiac masses, while CT and MRI

Echocardiography provides useful information about the size, texture, location, extension of

Cardiac tumors can be found incidentally such as myxoma or left atrial thrombus in a patient with mitral stenosis. There is also different clinical presentation for cardiac masses

Two groups of tumors can involve the heart: primary and secondary tumors. Primary tumors are rare with a prevalence of 0.001 to 0.03 percent in autopsies (1).The majority of primary tumors are benign such as myxoma, the most common form of primary tumors, responsible for half of these tumors (2). One fourth of cardiac tumors are malignant, and sarcomas with primary cardiac lymphomas are the most common malignant primary

Malignant primary cardiac tumors include: angiosarcoma, rhabdomyosarcoma, osteosarcoma, myxosarcoma, fibrosarcoma and synovial sarcoma. Various sarcomas and

Metastatic tumors are 20 to 40 times more common than primary malignant ones with prevalence of 6% in post-mortem autopsies in malignant diseases (6). The most common tumors that metastasize to heart are from lung, breast, kidney, and liver; and among tumor

Malignant tumors can metastasize to heart via hematogenous spread from inferior vena cava such as renal and hepatic tumors or via metastatic formation by systemic tumors such

lymphomas are the most common primary malignant cardiac tumors (4, 5).

provide more information about the texture and extension of tumor.

tumors, hemodynamic effects on heart such as stenosis.

such as constitutional symptoms, embolic events, fever etc.

variety, lymphoma, melanoma and osteogenic sarcoma (2).

**1. Introduction** 

cardiac tumors (3).

*Baqiyatallah University of Medical Sciences,* 

