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Kawasaki disease — USMLE Step 3 MCQ

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HardPediatrics (well-child, chronic management)Kawasaki diseaseUSMLE Step 3

A child with prior Kawasaki disease has a persistent giant coronary aneurysm. Which long-term antithrombotic strategy is appropriate?

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Correct answer: A — Aspirin plus therapeutic warfarin or low-molecular-weight heparin

The best answer is “Aspirin plus therapeutic warfarin or low-molecular-weight heparin”. Giant aneurysms confer high thrombosis risk requiring combined antiplatelet and anticoagulant therapy. Giant coronary aneurysms after Kawasaki disease require low-dose aspirin plus systemic anticoagulation such as warfarin or low-molecular-weight heparin. The alternatives use a different threshold, timing, population, or intervention and therefore do not match the clinical facts presented.

Reference: AHA: Kawasaki Disease Update: https://newsroom.heart.org/news/early-detection-intensive-treatment-critical-for-high-risk-patients-with-kawasaki-disease