How Is Kawasaki Disease Treated?

Medicines are the main treatment for Kawasaki disease. Rarely, children whose coronary (heart) arteries are affected may need medical procedures or surgery.

The goals of treatment include:

• Reducing fever and inflammation to improve symptoms
• Preventing the disease from affecting the coronary arteries

Initial Treatment

Kawasaki disease can cause serious health problems. Thus, your child will likely be treated in a hospital, at least for the early part of treatment.

The standard treatment during the disease's acute phase is high-dose aspirin and immune globulin. Immune globulin is a medicine that's injected into a vein.

Most children who receive these treatments improve greatly within 24 hours. For a small number of children, fever remains. These children may need a second round of immune globulin.

At the start of treatment, your child will receive high doses of aspirin. As soon as his or her fever goes away, a low dose of aspirin is given. The low dose helps prevent blood clots, which can form in the inflamed small arteries.

Most children treated for Kawasaki disease fully recover from the acute phase and don't need any further treatment. They should, however, follow a healthy diet and adopt healthy lifestyle habits. Taking these steps can help lower the risk of future heart disease. (Following a healthy lifestyle is advised for all children, not just those who have Kawasaki disease.)

Children who have had immune globulin should wait 11 months before having the measles and chicken pox vaccines. Immune globulin can prevent those vaccines from working well.

Long-Term Care and Treatment

If Kawasaki disease has affected your child's coronary arteries, he or she will need ongoing care and treatment.

It's best if a pediatric cardiologist provides this care to reduce the risk of severe heart problems. A pediatric cardiologist is a doctor who specializes in treating children who have heart problems.

Medicines and Tests

When Kawasaki disease affects the coronary arteries, they may expand and twist. If this happens, your child's doctor may prescribe blood-thinning medicines (for example, warfarin). These medicines help prevent blood clots from forming in the affected coronary arteries.

Blood-thinning medicines usually are stopped after the coronary arteries heal. Healing may occur about 18 months after the acute phase of the disease.

In a small number of children, the coronary arteries don't heal. These children likely will need routine tests, such as:

• Echocardiography. This test uses sound waves to create images of the heart.
• EKG (electrocardiogram). This test detects and records the heart's electrical activity.
• Stress test. This test provides information about how the heart works during physical activity or stress.

Medical Procedures and Surgery

Rarely, a child who has Kawasaki disease may need cardiac catheterization (KATH-eh-ter-ih-ZA-shun). Doctors use this procedure to diagnose and treat some heart conditions.

A flexible tube called a catheter is put into a blood vessel in the arm, groin (upper thigh), or neck and threaded to the heart. Through the catheter, doctors can perform tests and treatments on the heart.

Very rarely, a child may need to have other procedures or surgery if inflammation narrows his or her coronary arteries and blocks blood flow to the heart. Coronary angioplasty (AN-jee-oh-plas-tee), stent placement, or coronary artery bypass grafting (CABG) may be used.

Coronary angioplasty restores blood flow through narrowed or blocked coronary arteries. A thin tube with a balloon on the end is inserted into a blood vessel in the arm or groin. The tube is threaded to the narrowed or blocked coronary artery. Then, the balloon is inflated to widen the artery and restore blood flow.

A stent (small mesh tube) may be placed in the coronary artery during angioplasty. This device helps support the narrowed or weakened artery. A stent can improve blood flow and prevent the artery from bursting.

Rarely, a child may need to have CABG. This surgery is used to treat blocked coronary arteries. During CABG, a healthy artery or vein from another part of the body is connected, or grafted, to the blocked coronary artery.

The grafted artery or vein bypasses (that is, goes around) the blocked part of the coronary artery. This improves blood flow to the heart.

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