| Risk Level | Frequency of cardiac evaluation* | Inducible myocardial ischemia evaluation† | Type and frequency of additional cardiac evaluations | Evaluation of cardiovascular risk’s factors and follow-up‡ | Recommended physical activitiesǂ | Advice on reproduction |
|---|---|---|---|---|---|---|
| 1. Without compromise. | Can be discharged after 4 week to 12 months. | None. | None. | Check after a year. | Promotion counseling in every appointment. | Advice at the appropriate age without modification. |
| 2. Dilation only. | Discharged after a year and check every 2-5 years, if it persists. | None. | None. | Check after a year. | Promotion counseling in every appointment. | Advice at the appropriate age without modification. |
| 3.1 Small, present or persistent aneurysm. | Check after 6 months and then, annually. | Check every 2-3 years. | Can be contemplated every 3-5 years. | Check after a year. | Promotion counseling in every appointment, restrict contact. | Contraception and pregnancy precautions. |
| 3.2 Small aneurysm that returned to normal, or dilation only. | Check every 1-3 years (the echocardiogram can be omitted). | Check every 3-5 years. | Can be contemplated if there’s inducible ischemia. | Check after a year and then, every two years. | Promotion counseling in every appointment. | Advice at the appropriate age without modification. |
| 4.1 Medium, present or persistent aneurysm. | Check after 3, 6 and 12 months and then, annually. | Check every 1-3 years. | Can be contemplated every 2-5 years. | Check after a year. | Promotion counseling in every appointment, restrict contact. Self-limits. | Contraception and pregnancy precautions. |
| 4.2 Medium aneurysm that returned to small aneurysm. | Check annually. | Check every 2-3 years. | Can be contemplated every 3-5 years. | Check annually. | Promotion counseling in every appointment, restrict contact. Self-limits. | Contraception and pregnancy precautions. |
| 4.3 Medium aneurysm that returned to normal, or dilation only. | Check every 1-2 years (the echocardiogram can be omitted). | Check every 2-4 years. | Can be contemplated if there’s inducible ischemia. | Check every two years. | Promotion counseling in every appointment, restrict contact. Self-limits. | Contraception and pregnancy precautions. |
| 5.1 Large or giant aneurysm, present or persistent. | Check after 3, 6, 9 and 12 months and then, every 3-6 months. | Check every 6-12 months. | Basally within 2-6 months, can be contemplated every 1-5 years. | Check every 6-12 months. | Promotion counseling in every appointment, restrict contact. Self-limits. | Contraception and pregnancy precautions. |
| 5.2 Large or giant aneurysm that returned to medium aneurysm. | Check every 6-12 months. | Check annually. | Can be contemplated every 2-5 years. | Check annually. | Promotion counseling in every appointment, restrict contact. Self-limits. | Contraception and pregnancy precautions. |
| 5.3 Large or giant aneurysm that returned to small aneurysm. | Check every 6-12 months. | Check every 1-2 years. | Can be contemplated every 2-5 years. | Check annually. | Promotion counseling in every appointment, restrict contact. Self-limits. | Contraception and pregnancy precautions. |
| 5.4 Large or giant aneurysm that returned to normal, or dilation only. | Check every 1-2 years (the echocardiogram can be omitted). | Check every 2-3 years. | Can be contemplated every 2-5 years. | Check every two years. | Promotion counseling in every appointment, restrict contact. Self-limits. | Contraception and pregnancy precautions. |
+5411 4493 7422 | [email protected]
Guidelines
Long-term evaluation and counseling algorithm
Source: Mc Crindle B. Rowley A. Newburger J. et al. Diagnosis, treatment, and long-term management of Kawasaki disease. Circulation 2017; 135 (17): e927- e999.
Cream: Class IIa recommendation (Reasonable to do)
Pink: Class IIB recommendation (Could be considered)
* Includes History and physical exam. Echocardiogram and ECG.
† Can include stress echocardiogram, stress ECG, stress perfusion imaging with NMR and stress with nuclear medicine imaging.
‡ In every consult, the doctor must offer general advice for a healthy lifestyle (it can be done by the primary care physician).
ǂ Contact restrictions are only applied to patients with anticoagulation or dual antiplatelet therapy; self-limit refers to allowing the patients to participate with their reasoning capabilities without coercion or pressure to do or overexert (themselves, parents or coaches)
† Can include stress echocardiogram, stress ECG, stress perfusion imaging with NMR and stress with nuclear medicine imaging.
‡ In every consult, the doctor must offer general advice for a healthy lifestyle (it can be done by the primary care physician).
ǂ Contact restrictions are only applied to patients with anticoagulation or dual antiplatelet therapy; self-limit refers to allowing the patients to participate with their reasoning capabilities without coercion or pressure to do or overexert (themselves, parents or coaches)