Table 2.
Summary of JCS guidelines regarding the follow-up of patients with Kawasaki disease, starting at 1 year
| Diagnostic testing | Interval | Invasive testing | |
|---|---|---|---|
| No or transient CAAa | Exercise ECG + echocardiogram | Once, 5 years after disease b | None |
| Small CAA (≤4 mm)a | |||
| - Regressed | (Exercise) ECG + echocardiogram | Annual until age 7 Triennial until age 16 |
None |
| - Persisting | (Exercise) ECG + echocardiogram | 3 months (until normalisation) | None |
| - Regressed or persisting | In patients ≥ 10 years after onset, consider MDCT or MRCA at final evaluation. | ||
| Medium CAA (>4 − <8 mm)a | |||
| A. CAA > 4 − <6 mm | |||
| - Regressed | ECG + echocardiogram X-ray + exercise ECG when necessary/feasible MDCT or MRCA |
Annual 5 years |
Selective CAG on individual basis |
| - Persisting | ECG + echocardiogram X-ray + exercise ECG when necessary/feasible MDCT or MRCA |
3–6 months 5 years |
Selective CAG on individual basis |
| B. CAA 6 − <8 mm | |||
| - Regressed | ECG + echocardiogram X-ray + exercise ECG when necessary/feasible MDCT or MRCA Appropriate combination of techniques c |
Annual 5 years |
Invasive CAG once during convalescence and at time of disappearance of dilatation |
| - Persisting | ECG + echocardiogram X-ray + exercise ECG when necessary/feasible MDCT or MRCA Appropriate combination of techniques c |
3–6 months 5 years |
Invasive CAG once during convalescence and at time of disappearance of dilatation |
| Giant CAA (≥8 mm)a | Tailor-made treatment with appropriate combination of (exercise) ECG, echocardiogram and other techniques c | 3–6 months | Invasive CAG during early convalescence phase |
From: Group JCSJW: Circ J 2014, 78(10):2521–25628
MDCT Multidetector CT, MRCA MR Coronary Angiography
aMeasured at 30 days after the onset of KD
bAdditional follow-up from the second to fifth year and after the fifth year can be scheduled individually through consultation between patient and physician
cImaging techniques include stress echocardiography, stress myocardial perfusion scintigraphy, invasive coronary angiography (CAG), Intravenous Ultrasound, Cardiac Magnetic Resonance Imaging, Magnetic Resonance Angiography and Multidetector CT