What is the appropriate follow up for patients with kawasaki disease after discharge from the hospital?
Patients without coronary artery lesions should be seen by a pediatric cardiologist and repeat ECHOs obtained approximately 1–2 weeks and 6 weeks after discharge from the hospital. If ECHOs remain normal, patients may discontinue thromboprophylaxis with aspirin. Patients should also be seen at 1-year follow-up for repeat ECHO and lipid profile testing. Some experts recommend follow-up every 5 years thereafter with exercise stress testing and lipid profile testing. General heart healthy lifestyle counseling should be provided at all visits. For patients with coronary artery lesions, much closer and more aggressive follow-up with cardiology is indicated. Thromboprophylaxis with aspirin, clopidogrel, warfarin, and/or low molecular heparin is decided based upon the size and location of the coronary artery lesions as well as the presence or absence of thrombosis. Medical therapies with β-blockers, angiotensin-converting enzyme inhibitors, and statins may also need to be considered.
