During the acute phase, Kawasaki Disease causes medium and large vessel arteritis. Therefore, baseline echocardiography is needed. Of particular concern are the coronary artery aneurysms which may predispose to stasis of blood, subsequent thrombosis, and overtime potential evolution into segmental thrombosis in the chronic phase. Coronary artery aneurysms are so unique to Kawasaki that when they are identified, strict adherence to fulfilling 4 or 5 of the diagnostic criteria is not done. The American Heart Association committee guidelines for long term follow-up and management are based upon the degree of coronary artery involvement.
Management includes anticoagulants, especially anti-platelet medications such as aspirin.
It is recommended to discontinue the use of aspirin with influenza illness and with Varicella vaccine administration because of the risk of Reye's Syndrome. Influenza Vaccine should also be considered for these patients. Testing may include repeated echocardiography, electrocardiogram, stress testing and angiography. In most patients, coronary artery aneurysms regress within two years of the illness. A rare complication is peripheral ischemia, which can cause gangrene.