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Classification of coronary artery abnormalities in children with Kawasaki disease[1,2]

Classification of coronary artery abnormalities in children with Kawasaki disease[1,2]
Classification Size of coronary artery abnormality*
No coronary involvement Z-score always <2 and no more than a 0.9 decrease in Z-score during follow-up
Dilation only Z-score 2 to <2.5 or if initially <2, a ≥1 decrease in Z-score during follow-up
Small aneurysm Z-score ≥2.5 to <5
Medium aneurysm Z-score of ≥5 to <10 and absolute dimension <8 mm
Large aneurysm or giant aneurysm Z-score ≥10 or absolute dimension ≥8 mm
* Size is classified according to internal lumen diameter, normalized for body surface area as Z-scores or standard deviation units.
¶ Some children who have coronary artery dimensions within the normal range (ie, Z-score <2) have substantial reduction in coronary artery dimension over time, suggesting that the coronary artery was initially dilated. Such patients are categorized as "dilation only" despite always having coronary artery dimensions within the normal range.
References:
  1. McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation 2017; 135:e927.
  2. Manlhiot C, Millar K, Golding F, McCrindle BW. Improved classification of coronary artery abnormalities based only on coronary artery z-scores after Kawasaki disease. Pediatr Cardiol 2010; 31:242.
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