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Andersons pediatric cardiology 1396

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and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association Circulation 2017;135(17):e927–e999 In the most recent American Heart Association guidelines on the management of patients with Kawasaki disease, coronary artery aneurysms are classified using the z-score to account for body surface area.2 The use of such z-scores has suggested that the previously used Japanese Ministry of Health criteria may underdiagnose and underestimate the true prevalence of coronary artery dilation A small aneurysm is defined as a z-score of 2.5 to less than 5, medium aneurysm as a z-score of 5 to less than 10 and absolute dimension less than 8 mm, and a large or giant aneurysm as z-score 10 or greater or absolute dimension 8 mm or greater (Table 53.1).2,105–107 However, with most calculators, z-scores are available only for the left main coronary artery and the proximal segments of the left anterior descending and right coronary arteries For distal coronaries, the Japanese Ministry of Health criteria should still be applied (small,

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