Kawasaki disease (KD), an acute self-limited febrile illness that primarily affects children <5 years old, is the leading cause of acquired heart disease in developed countries, with the potential of leading to coronary artery dilation and coronary artery aneurysms in 25% of untreated patients. This update summarizes relevant clinical data published since the 2017 American Heart Association scientific statement on KD related to diagnosis, cardiac imaging in acute KD treatment, and long-term management. Criteria defining North American patients at high risk for developing coronary artery aneurysms who may benefit from more intensive initial treatment have been published. Advances in cardiovascular imaging have improved the ability to identify coronary artery stenosis in patients with KD, yet knowledge gaps remain regarding optimal frequency of serial imaging and the best imaging modality to identify those at risk for inducible myocardial ischemia. Recent data have advanced the understanding of safety and dosing for several anti-inflammatory therapies in KD. New anticoagulation medication, myocardial infarction management, transition of health care for patients with KD, and future directions in research are discussed.

川崎病（Kawasaki disease，KD）是一种主要影响5岁以下儿童的急性自限性发热性疾病，是发达国家获得性心脏病的主要原因，25%未经治疗的患者可能导致冠状动脉扩张和冠状动脉瘤。本更新总结了自2017年美国心脏协会关于KD的科学声明以来发表的与诊断、急性KD治疗中的心脏成像和长期管理相关的相关临床数据。北美冠状动脉瘤高危患者的标准已经公布，这些患者可能从更密集的初始治疗中获益。心血管影像学的进步提高了识别KD患者冠状动脉狭窄的能力，但关于识别诱发性心肌缺血风险的最佳连续成像频率和最佳成像方式的知识差距仍然存在。最近的数据提高了对KD中几种抗炎治疗的安全性和剂量的认识。本文讨论了新的抗凝药物、心肌梗死的处理、KD患者的医疗保健转变以及未来的研究方向。