Kawasaki Disease Cardiology Follow-Up Note

Date: [Date]

Patient: [Patient name or identifier]

Age/Sex: [Age] / [Sex]

Visit Type: KD cardiology follow-up

Interval Since Last Cardiology Visit: [Interval]

KD History & Coronary Status

[Brief KD episode synopsis including onset date, IVIG timing, and adjunctive therapies as needed to contextualize coronary risk]

• Max-Ever Coronary Status: [Largest documented Z-score], [date], [affected segment(s)] (If unavailable, state "unknown—records requested.")
• Current Coronary Status: [Most recent Z-scores by segment, at minimum proximal LAD and proximal RCA], [date]
• AHA Risk Level: [Max-ever-based classification] / [Current classification] (State both. Do not infer risk level without explicit Z-scores.)

Interval History

[Interval symptoms and functional status: chest pain, exertional dyspnea, palpitations, syncope, bleeding/bruising]

[Medication adherence and any barriers]

[Intercurrent illnesses, hospitalizations, or influenza/varicella exposures if on aspirin] (Omit unrelated review of systems.)

Objective

Vitals: [BP, HR, weight, height, calculated BSA]

Exam: [Focused cardiovascular exam: rate, rhythm, murmurs, pulses, perfusion; skin if on antithrombotics; respiratory if symptomatic]

Imaging Summary:

• [Date] — [Modality] — [BSA] — [Z-scores by segment] — [stable / regressed / progressed]
• (Add rows for prior key studies to create timeline.)

[Z-score normative dataset if known] [Outside reports pending and action to obtain]

Other Data: [ECG, stress testing, relevant labs] (Only if reviewed this visit.)

Assessment

History of Kawasaki disease with [current coronary status], max-ever [category], AHA risk level [level]. [Brief statement on clinical stability with supporting evidence from serial imaging and symptoms.] [Other active cardiac problems if present.]

Plan

• Coronary Surveillance:

  • [Next echo timing with rationale tied to AHA risk level]
  • [Ischemia testing: indicated / not indicated; modality and timing if applicable]
  • [Advanced imaging (CTA/CMR/angiography) if indicated with rationale]
  • Expedite imaging if new exertional symptoms develop.

• Antithrombotic Therapy:

  • [Agent(s), dose in mg/kg and absolute mg, indication linked to risk level]
  • [Monitoring: INR or anti-Xa target and frequency if on anticoagulation]
  • [Bleeding precautions, NSAID avoidance]
  • [Influenza/varicella vaccination status and exposure plan if on aspirin]
  • (If anticoagulation considered but not initiated, document reasoning.)

• Activity Guidance: [Encourage age-appropriate aerobic activity. If on anticoagulation or dual antiplatelet therapy, restrict contact/collision sports. Competitive sports clearance: granted / deferred pending testing.]

• CV Risk Factor Counseling: [BP, weight, diet, activity, smoking/vaping exposure as applicable]

• IE Prophylaxis: Infective endocarditis prophylaxis is not indicated for KD history alone. (Modify only if unrelated structural heart disease is present.)

• Transition/Reproductive Counseling: [Transition readiness, receiving adult cardiology provider; reproductive counseling including contraception and preconception planning if aneurysm history or on anticoagulation] (Include if age-appropriate.)

• Return Precautions: Seek urgent evaluation for new exertional chest pain, syncope, severe dyspnea, neurologic symptoms, or uncontrolled bleeding.

• Follow-Up: [Next cardiology appointment timing and planned tests] [Action items for missing records if applicable]