Kawasaki disease (KD), an acute self-limited febrile illness that primarily affects children <5 years old, is the leading cause of acquired heart disease in developed countries, with the potential of leading to coronary artery dilation and coronary artery aneurysms in 25% of untreated patients. This update summarizes relevant clinical data published since the 2017 American Heart Association scientific statement on KD related to diagnosis, cardiac imaging in acute KD treatment, and long-term management. Criteria defining North American patients at high risk for developing coronary artery aneurysms who may benefit from more intensive initial treatment have been published. Advances in cardiovascular imaging have improved the ability to identify coronary artery stenosis in patients with KD, yet knowledge gaps remain regarding optimal frequency of serial imaging and the best imaging modality to identify those at risk for inducible myocardial ischemia. Recent data have advanced the understanding of safety and dosing for several anti-inflammatory therapies in KD. New anticoagulation medication, myocardial infarction management, transition of health care for patients with KD, and future directions in research are discussed.

中文翻译：

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川崎病诊断和管理的更新：美国心脏协会的科学声明。


川崎病 （KD） 是一种急性自限性发热性疾病，主要影响 <5 岁的儿童，是发达国家获得性心脏病的主要原因，可能导致 25% 未经治疗的患者出现冠状动脉扩张和冠状动脉瘤。本更新总结了自 2017 年美国心脏协会关于 KD 的科学声明以来发表的与诊断、急性 KD 治疗中的心脏影像学和长期管理相关的临床数据。定义可能从更强化的初始治疗中受益的冠状动脉瘤高危北美患者的标准已经发布。心血管影像学的进步提高了识别 KD 患者冠状动脉狭窄的能力，但在连续影像学检查的最佳频率和识别有诱发性心肌缺血风险的患者的最佳影像学检查方式方面仍然存在知识差距。最近的数据加深了对 KD 中几种抗炎疗法的安全性和剂量的理解。讨论了新的抗凝药物、心肌梗死管理、KD 患者医疗保健的过渡以及未来的研究方向。