ECG findings after myocardial infarction in children after Kawasaki disease.
Standard 12-lead ECGs were evaluated in 17 children with myocardial infarction and 78 children without myocardial infarction after Kawasaki disease; sensitivity and specificity of the ECG infarction criteria were determined. The presence or absence of myocardial infarction was determined from either clinical examination results (coronary angiography, ventriculography, and thallium-201 myocardial imaging) or autopsy findings. Of seven patients with inferior infarction, abnormally deep Q waves in lead II, III, or aVF were observed in six, but the duration was greater than 0.04 second in only one (14%). The sensitivity and specificity of inferior infarction criteria based on Q wave amplitude were 86% and 97%, respectively. Of eight patients with anterior infarction, seven (88%) had abnormally deep and wide (greater than or equal to 0.04 second) Q waves in anterior chest leads. The sensitivity and specificity of the infarction criteria based on the amplitude and duration of the Q wave were 75% and 99%, respectively. Of seven patients with lateral infarction, Q waves were observed in lead I, aVL, or both in four patients, and in all of these patients Q waves were wider than 0.04 second. In two patients with both inferior and anterior infarction, Q waves were observed only in leads II, III, and aVF; in only one patient were the Q waves wider than 0.04 second. Thus deep Q waves in lead II, III, or aVF that are not wider than 0.04 second may indicate inferior infarction in children. Q waves in lead I, aVL, and chest leads associated with anterolateral infarction are in most instances deep and wide.
Nakanishi
T
T
Department of Pediatric Cardiology, Heart Institute of Japan, Tokyo.
Takao
A
A
Kondoh
C
C
Nakazawa
M
M
Hiroe
M
M
Matsumoto
Y
Y
D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed
D013794:Thallium Radioisotopes