Administration of moderate dose ASA (ASPRIN*) (30–50 mg/kg/d) is given until the patient is afebrile and after Low-dose ASA (3–5 mg/kg/d) is continued as guided by Z scores on ECHO as follows-
Z score < 2.0 (No coronary abnormality) the low dose aspirin is given for 6-8 weeks till all inflammatory parameters normalize.
Z score 2 to <2.5 the low dose aspirin is given for 6-8 weeks till all parameters normalize including the transient coronary dilatation.
Z score between 2.5 to <5 (Small Aneurysm), the low dose aspirin is given for the long term with regular Pediatric Cardiologist & Rheumatologist follow ups.
Z score 5 to <10 the low dose aspirin is given for long term and anticoagulants/antiplatelet(clopidogrel) may be added as guided by cardiologist, with close monitoring and follow up.
Z score is > 10 the child has to be given anticoagulation (Nicoumalone/ACITROM*) plus aspirin for long term and needs close monitoring as there is a high risk of thrombosis.
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