Long-Term Follow-Up and Education Regarding Daily Life Activities, School Life, and Guidelines After Acute KD

Abstract

Almost all patients with Kawasaki disease take aspirin for 2–3 months after disease onset. During and after such treatment, patients without coronary artery lesions (CAL) are not restricted with respect to sports, vaccination, or normal daily life activities. Management of daily life activities of patients with CAL depends on individual risk of cardiac events, as determined by appropriate assessment techniques. If the patient requires anticoagulant and/or antiplatelet treatment, external injuries should be avoided and participation in contact sports restricted. When warfarin is used, the dose needs to be carefully monitored by blood testing, and the patient should be informed about foods that increase vitamin K levels. Angiograms obtained by computed tomography or magnetic resonance are beginning to supplant catheter angiograms in the morphological evaluation of CAL; however, these modalities have advantages and disadvantages. Echocardiography and scintigraphy with pharmacological or exercise stress testing is useful in functional studies. However, an experienced examiner must be available to conduct and evaluate the results of such tests. As patients age, they must be made aware of the possibility of cardiac sequelae and the need for transition to an adult cardiologist.