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Long-term cardiovascular follow-up in children with Kawasaki disease according to coronary artery status

Coronary artery status	Frequency of cardiology assessment*	Assessment for inducible myocardial ischemia^¶	Type and frequency of additional cardiology assessment	Cardiovascular risk factor assessment and management^Δ	Physical activity counseling^◊	Reproductive counseling
1: No involvement	May discharge between 4 weeks and 12 months	None	None	Assess at 1 year	Promotion counseling at every visit	Age-appropriate counseling without modification
2: Dilation only	If dilation persists, assess every 2 to 5 years If dilation regresses to normal, may discharge after 4 weeks to 12 months	None	None	Assess at 1 year	Promotion counseling at every visit	Age-appropriate counseling without modification
3.1: Small aneurysm, current or persistent	Assess at 6 months, then yearly	Assess every 2 to 3 years	May consider every 3 to 5 years	Assess at 1 year	Promotion counseling at every visit; restrict contact	Age-appropriate counseling without modification
3.2: Small aneurysm, regressed to normal or dilation only	Assess every 1 to 3 years (may omit echocardiography)	Assess every 3 to 5 years	May consider if there is inducible ischemia or ventricular dysfunction	Assess at 1 year, then every 2 years	Promotion counseling at every visit	Age-appropriate counseling without modification
4.1: Medium aneurysm, current or persistent	Assess at 3, 6, and 12 months, then every 6 to 12 months	Assess every 1 to 3 years	May consider every 2 to 5 years	Assess at 1 year	Promotion counseling at every visit; restrict contact; self-limit	Precautions for contraception and pregnancy
4.2: Medium aneurysm, regressed to small aneurysm	Assess yearly	Assess every 2 to 3 years	May consider every 3 to 5 years	Assess yearly	Promotion counseling at every visit; restrict contact; self-limit	Precautions for contraception and pregnancy
4.3: Medium aneurysm, regressed to normal or dilation only	Assess every 1 to 2 years (may omit echocardiography)	Assess every 2 to 5 years	May consider if there is inducible ischemia or ventricular dysfunction	Assess every 2 years	Promotion counseling at every visit; restrict contact; self-limit	Precautions for contraception and pregnancy
5.1: Large or giant aneurysm, current or persistent	Assess at 3, 6, 9, and 12 months, then every 3 to 6 months	Assess every 6 to 12 months	Baseline within first year; may consider every 1 to 5 years	Assess every 6 to 12 months	Promotion counseling at every visit; restrict contact; self-limit	Precautions for contraception and pregnancy
5.2: Large or giant aneurysms, regressed to medium aneurysm	Assess every 6 to 12 months	Assess 1 to 2 years	May consider every 2 to 5 years	Assess yearly	Promotion counseling at every visit; restrict contact; self-limit	Precautions for contraception and pregnancy
5.3: Large or giant aneurysm, regressed to small aneurysm	Assess every 6 to 12 months	Assess every 2 to 3 years	May consider every 3 to 5 years	Assess yearly	Promotion counseling at every visit; restrict contact; self-limit	Precautions for contraception and pregnancy
5.4: Large or giant aneurysm, regressed to normal or dilation only	Assess every 1 to 2 years (may omit echocardiography)	Assess every 2 to 5 years	May consider every 5 years	Assess every 2 years	Promotion counseling at every visit; restrict contact; self-limit	Precautions for contraception and pregnancy

* Includes history, physical examination, echocardiography, and electrocardiography.
¶ May include stress echocardiography, stress electrocardiography, stress with magnetic resonance perfusion imaging, and stress with nuclear medicine perfusion imaging.
Δ General healthy lifestyle counseling should be provided at every visit (may be performed by primary care provider).
◊ Restrictions for contact apply to patients on anticoagulation or dual antiplatelet therapy; self-limit refers to allowing patients to participate to their reasonable abilities without coercion or pressure to perform or overexert (self, parents, coaches).

Reprinted with permission. Circulation 2017; 135(17):e927-e999. Copyright © 2017 American Heart Association, Inc. This table has been updated to reflect corrections published in Circulation 2019; 140(5):e181-e184.

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