What is the long-term monitoring for patients with Kawasaki disease?

Updated: Jul 29, 2018
  • Author: Tina K Sosa, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Long-term management begins at the end of the acute illness, typically 5-6 weeks after fever onset. This is typically when coronary artery involvement has reached its maximal extent and luminal dimensions. Thromboprophylaxis and careful echocardiographic surveillance for coronary artery stenoses and obstructions, as well as myocardial ischemia, are the pillars of management. Patients with severe cardiac complications may require catheterization, coronary artery bypass surgery, or even cardiac transplantation. Successful long-term management requires effective and collaborative programs between pediatric and adult cardiologists. [2]

Frequency of follow up, medication use, and imaging evaluations are highly dependent on the disease severity. For patients with no evidence of cardiac involvement during the acute phase, they are often discharged from cardiology care at 4-6 weeks after the onset of symptoms without any chronic follow up required. Patients with cardiac disease are treated and monitored regularly by cardiologists with the exact medications used and follow up frequency determined by their provider. [2]


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