Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease

Over 35 years have elapsed since the first case of Kawasaki disease was described in 1967. 1 As they grow older, many patients with a history of Kawasaki disease are treated in departments of internal medicine rather than in pediatric departments. This disease has been extensively studied throughout the world, and many reports have been published on its etiology and cardiovascular sequelae. While the causes of Kawasaki disease unfortunately remain unknown, its cardiovascular sequelae have been intensively studied, contributing to the establishment of their pathology, natural history, diagnosis, and treatment. This provided the impetus for the Japanese Circulation Society to prepare a set of guidelines. The latest guidelines for the diagnosis of Kawasaki disease, as revised in 2002, are shown in Table 1. These are used to diagnose the disease in its acute phase. The diagnostic guidelines may be useful in adults with an unknown history of Kawasaki disease when the illness is suspected from the morphology of any coronary artery aneurysms. In preparing the present guidelines for the cardiovascular sequelae of Kawasaki disease, the first issue addressed was the classification of the size and severity of coronary artery aneurysms using standardized criteria. The consensus criteria shown in Table 2 were prepared according to the conventional classification and the opinions of specialists.