Infants under 6 months higher incomplete presentation risk
Weight based dosing for IVIG and aspirin
Early echocardiography and repeat schedule
MIS C differentiation in school age children and adolescents
Hypotension and GI symptoms more prominent in MIS C
Cardiac dysfunction common in both
Background
Epidemiology
Epidemiology facts
Most common cause of acquired heart disease in children in high income countries
Highest incidence in children under 5 years
Male predominance
Seasonal clustering in some regions
Pathophysiology
Disease mechanism
Medium vessel vasculitis with coronary artery predilection
Endothelial inflammation leading to aneurysm formation
Myocarditis in acute phase contributing to shock
Thrombosis risk in large aneurysms
Therapeutic Considerations
Treatment rationale
IVIG reduces coronary artery aneurysm risk when given early
Aspirin used for anti inflammatory and antiplatelet effects
Early identification of high risk patients for intensified therapy focus in 2024 AHA update
Coronary Z score based risk stratification guides follow up and thromboprophylaxis
Patient Discharge Instructions
copy discharge instructions
Home care and follow up plan
Aspirin exactly as prescribed
Avoid ibuprofen unless cardiology approves
Cardiology follow up appointment attendance
Echocardiography follow up attendance
Live vaccines delayed after IVIG per immunization guidance
Fever diary for recurrence after discharge
Return to emergency criteria
Fever recurrence
Breathing difficulty
Chest pain
Fainting
New severe abdominal pain
Signs of dehydration
Bleeding or black stools while on aspirin
New swelling of hands or feet
Extreme sleepiness or confusion
References
Clinical guidelines and key sources
Guideline sources
American Heart Association scientific statement update on Kawasaki disease 2024
American Heart Association statement diagnosis treatment and long term management 2017
ACC summary of AHA 2017 ten points to remember
Royal Childrens Hospital Melbourne clinical practice guideline Kawasaki disease
Evidence summaries and recent studies
Evidence sources
JAMA Network Open 2025 aspirin dosing and outcomes in Kawasaki disease
Cochrane style evidence review IVIG and aspirin regimens 2023
File reference for formatting and structure
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.