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Sports_Coronary_Kawasaki_Overview.html
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Sports_Coronary_Kawasaki_Overview.html
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<!DOCTYPE html>
<html lang="en">
<!-- defines the default zoom for mobile devices -->
<meta name="viewport" content="width=device-width, initial-scale=1" />
<head>
<meta charset="UTF-8">
<title>CardioRef: AHA/ACC 2015 Sports Participation Selector Guide: Kawasaki</title>
<link rel="stylesheet" href="css/sports_answer_combined.css">
<style>
div{
-webkit-margin-before:0;
-webkit-margin-after:0;
-webkit-margin-start:0;
-webkit-margin-end:0;
}
</style>
</head>
<body>
<div class="topbar">
<a href="index.html">Pedi CardioRef</a>
<div class="guidelinebar">
<a target="_blank" rel="noopener noreferrer" href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000244">
Reference: ACC/AHA Sports Participation Recommendations (Circulation 2015) Task Force 8: Coronary Artery Disease</a>
</div>
</div>
<section style="margin:10px">
<p class="topspace"></p>
<label><b>By the ACC/AHA 2015 guidelines, should my patient with</label>
<select name="disease" id="dz" class="InputBox" onChange="goThere();">
<option value="">*Select Disease*</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HCM">Hypertrophic Cardiomyopathy </option>
<option value="LVNC">Left Ventricular Non-Compaction </option>
<option value="DilRestr">Dilated or Restrictive Cardiomyopathy </option>
<option value="ARVC">Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) </option>
<option value="Myo">Myocarditis </option>
<option value="Peri">Pericarditis </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="ASDVSDPDA">ASD, VSD, or PDA </option>
<option value="PS">Pulmonic Stenosis </option>
<option value="AS">Aortic Stenosis </option>
<option value="Coarct">Coarctation </option>
<option value="Cyan">Cyanotic Heart Disease, unrepaired or with palliative shunt </option>
<option value="TOF">Tetralogy of Fallot, s/p repair </option>
<option value="TGA_Must">d-transposition (d-TGA), s/p atrial switch (Mustard/Senning)</option>
<option value="TGA_Art">d-transposition (d-TGA), s/p arterial switch </option>
<option value="CCTGA">Congenitally-corrected TGA (CC-TGA, L-TGA)</option>
<option value="Fontan">Fontan </option>
<option value="Ebstein">Ebstein Anomaly </option>
<option value="AnomCoronary">Anomalous Coronary Artery Origin</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="PVR">Elevated PVR in CHD </option>
<option value="VentricularDysfxn">Ventricular Dysfunction s/p CHD Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Valve_AS">Aortic Stenosis</option>
<option value="Valve_AR">Aortic Regurgitation </option>
<option value="Valve_MS">Mitral Stenosis</option>
<option value="Valve_MR">Mitral Regurgitation </option>
<option value="Valve_Hx">History of Mitral or Aortic Valve Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HTN">Hypertension </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="AoDiseases_and_Marfan">Aortic Diseases and Marfan Syndrome</option>
<option value="BAV">Bicuspid Aortic Valve</option>
<option value="Marfan">Marfan Syndrome</option>
<option value="TAA">Thoracic Aortic Aneurysm, familial or unexplained</option>
<option value="LoeysDietz_EhlersDanlos">Loeys-Dietz or vascular Ehlers-Danlos</option>
<option value="AoEnlarge">Enlarged Aorta, non-syndrome non-familial</option>
<option value="Ao_Surgery">S/p Surgery for Aortic Enlargement/Dissection</option>
<option value="Chronic_AoDissection">Chronic Aortic Dissection or Branch Aneurysm</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="CoronaryOverview">Coronary Artery Disease </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Syncope">Syncope </option>
<option value="Arrhythmia">Arrhythmias (SVT, PVC, Vtach, etc.) </option>
<option value="ConductionDefect">Conduction Defects (AV block, brady, pacemaker, RBBB/LBBB)</option>
<option value="Channelopathies">Channelopathies (LQTS, CPVT, Brugada, etc.) </option>
<option value="ICD">Implantable Cardioverter-Defibrillator (ICD) </option>
</select>
<span>participate in organized sports?</span></b>
<br><br>
<section id="question">
Should my patient with <b>Coronary Artery Disease</b> participate in organized sports?
</section>
</section>
<!-- End of 10px margin section. Consider changing template. -->
<br>
<!-- navigation bar for disease sub-categories -->
<nav>
<a href="Sports_Coronary_Athero_Overview.html">Atherosclerotic Coronary Disease</a>
<a href="Sports_Coronary_Spasm_Overview.html">Coronary Spasm</a>
<a href="Sports_Coronary_Dissection_Overview.html">Coronary Artery Dissection</a>
<a href="Sports_Coronary_Bridging_Overview.html">Myocardial Bridging</a>
<a href="Sports_Coronary_Kawasaki_Overview.html" class="active">Kawasaki</a>
<a href="Sports_Coronary_Vasculitis_Overview.html">Coronary Vasculitis</a>
<a href="Sports_Coronary_Transplant_Overview.html">Transplant Coronary Vasculopathy</a>
</nav>
<div class="largeanswerbox">
<h2 align=center>Kawasaki Disease</h2>
<hr>
<section id="needtoknow">
<p class="sectiontitle">Need to know:</p>
<ul>
<li>Aneurysm? Size:</li>
<ul>
<li>Small (< 1.5x normal, or < 5 mm)</li>
<li>Moderate (1.5-4x normal, or 5–8 mm)</li>
<li>Large (>4x normal, or >8 mm)</li>
</ul>
<li>Exercise test results</li>
<li>Myocardial infarction (MI) or revascularization?</li>
</ul>
</section>
<section id="answer_arrow_section">
<section class="fifth_invisible">⇙</section>
<section class="fifth_invisible">⇙</section>
<section class="fifth_invisible">⇓</section>
<section class="fifth_invisible">⇘</section>
<section class="fifth_invisible">⇘</section>
</section>
<section id="answer">
<section class="fifth_left">
<p class="sectiontitle">No aneurysms, no exercise-induced ischemia/arrhythmias</p>
<p>"Patients with no coronary aneurysms during the convalescent phase and with
no exercise-induced ischemia or arrhythmias may be considered for participation in
all sports starting 8 weeks after the illness has resolved."
</p>
<div class="verdict_maybe"><b>Can consider all sports, 8 weeks after illness resolved</b></div>
<p class="rec_class">(Class IIb Recommendation; Level of Evidence C)</p>
</section>
<section class="fifth_middleleft">
<p class="sectiontitle">Transient aneurysms, no exercise-induced ischemia/arrhythmias</p>
<p>
"Patients with transient coronary aneurysms and with no exercise-induced ischemia or arrhythmias
may be considered for participation in all sports 8 weeks after illness resolution.
Risk reassessment is recommended at 3- to 5-year intervals or according to current guidelines."
</p>
<div class="verdict_maybe"><b>Can consider all sports, 8 weeks after illness resolved</b> (and reassess q3-5 years)</div>
<p class="rec_class">(Class IIb Recommendation; Level of Evidence C)</p>
</section>
<section class="fifth_middle">
<p class="sectiontitle">Small to medium-sized aneurysms, no exercise-induced ischemia/arrhythmias</p>
<p>
"In the absence of exercise-induced ischemia or arrhythmias, it is reasonable for patients to participate in
low- to moderate-intensity static and dynamic competitive sports.
Patients with persistent small to medium-sized aneurysms in ≥1 coronary arteries should continue
antiplatelet therapy and undergo ongoing surveillance."
</p>
<div class="verdict_maybe"><b>Low- to moderate-intensity static and dynamic sports = reasonable.</b> Continue antiplatelet therapy. Continue surveillance.</div>
<p class="rec_class">(Class IIa Recommendation; Level of Evidence C)</p>
</section>
<section class="fifth_middleright">
<p class="sectiontitle">Large coronary aneurysm</p>
<p>"Patients with ≥1 large coronary aneurysms should continue antiplatelet therapy and possibly anticoagulant therapy.</p>
<p>It is also reasonable for annual stress tests
to be performed and activity to be guided by results, similar to adults with ASCAD."
</p>
<div class="verdict_maybe">Activity based on stress test results <a href="Sports_Coronary_Athero_Overview.html" class="icon">(<b>See ASCAD guidelines</b>)🔗</a></div>
<p class="rec_class">(Class I Recommendation; Level of Evidence C)</p>
</section>
<section class="fifth_right">
<p class="sectiontitle">MI or revascularization</p>
<p>
"Patients with myocardial infarction or revascularization
should follow the guidance for adults with ASCAD."
</p>
<div class="verdict_maybe"><a href="Sports_Coronary_Athero_Overview.html" class="icon"><b>See ASCAD guidelines</b>🔗</a></div>
<p class="rec_class">(Class I Recommendation; Level of Evidence A)</p>
</section>
</section>
<hr>
<section id ="notrecommend">
<p class="sectiontitle">Patients undergoing antiplatelet therapy</p>
<p>"Collision sports should be avoided in patients undergoing antiplatelet therapy."</p>
<div class="verdict_no2">No collision sports</div>
<p class="rec_class">(Class I Recommendation; Level of Evidence C)</p>
</section>
</div>
<p class="foot">
<b>Reference:</b> <a href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000244"><i>Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 8: Coronary Artery Disease.</a>
A Scientific Statement From the AHA and ACC. Circulation 2015</i>
<button class="test_me">
<a href="#">Read the whole thing, eh? Test your knowledge!</a>
</button>
<br><br><b>Disclaimer:</b> This website is derived from published guidelines, but does not constitute
medical advice nor does it replace clinical judgement. Only the text in quotation marks are direct
quotations from the original guidelines. Text not in quotations as well as the method of information
display are all that of the website creator and are not part of the original published guidelines.
Please consult a physician to discuss any patient-specific matters.
</p>
<section class="key">
<p><b>Key:</b>MI = myocardial infarction, ASCAD = atherosclerotic coronary artery disease
</p>
</section>
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