August 2025
| Coronary artery status | Frequency of cardiology assessment* | Assessment for inducible myocardial ischemia¶ | Type and frequency of additional cardiology assessment | Cardiovascular risk factor assessment and managementΔ | Physical activity counseling◊ | Reproductive counseling |
| 1: No involvement | May discharge between 4 weeks and 12 months | None | None | Assess at 1 year | Promotion counseling at every visit | Age-appropriate counseling without modification |
| 2: Dilation only | If dilation persists, assess every 2 to 5 years If dilation regresses to normal, may discharge after 4 weeks to 12 months | None | None | Assess at 1 year | Promotion counseling at every visit | Age-appropriate counseling without modification |
| 3.1: Small aneurysm, current or persistent | Assess at 6 months, then yearly | Assess every 2 to 3 years | May consider every 3 to 5 years | Assess at 1 year | Promotion counseling at every visit; restrict contact | Age-appropriate counseling without modification |
| 3.2: Small aneurysm, regressed to normal or dilation only | Assess every 1 to 3 years (may omit echocardiography) | Assess every 3 to 5 years | May consider if there is inducible ischemia or ventricular dysfunction | Assess at 1 year, then every 2 years | Promotion counseling at every visit | Age-appropriate counseling without modification |
| 4.1: Medium aneurysm, current or persistent | Assess at 3, 6, and 12 months, then every 6 to 12 months | Assess every 1 to 3 years | May consider every 2 to 5 years | Assess at 1 year | Promotion counseling at every visit; restrict contact; self-limit | Precautions for contraception and pregnancy |
| 4.2: Medium aneurysm, regressed to small aneurysm | Assess yearly | Assess every 2 to 3 years | May consider every 3 to 5 years | Assess yearly | Promotion counseling at every visit; restrict contact; self-limit | Precautions for contraception and pregnancy |
| 4.3: Medium aneurysm, regressed to normal or dilation only | Assess every 1 to 2 years (may omit echocardiography) | Assess every 2 to 5 years | May consider if there is inducible ischemia or ventricular dysfunction | Assess every 2 years | Promotion counseling at every visit; restrict contact; self-limit | Precautions for contraception and pregnancy |
| 5.1: Large or giant aneurysm, current or persistent | Assess at 3, 6, 9, and 12 months, then every 3 to 6 months | Assess every 6 to 12 months | Baseline within first year; may consider every 1 to 5 years | Assess every 6 to 12 months | Promotion counseling at every visit; restrict contact; self-limit | Precautions for contraception and pregnancy |
| 5.2: Large or giant aneurysms, regressed to medium aneurysm | Assess every 6 to 12 months | Assess 1 to 2 years | May consider every 2 to 5 years | Assess yearly | Promotion counseling at every visit; restrict contact; self-limit | Precautions for contraception and pregnancy |
| 5.3: Large or giant aneurysm, regressed to small aneurysm | Assess every 6 to 12 months | Assess every 2 to 3 years | May consider every 3 to 5 years | Assess yearly | Promotion counseling at every visit; restrict contact; self-limit | Precautions for contraception and pregnancy |
| 5.4: Large or giant aneurysm, regressed to normal or dilation only | Assess every 1 to 2 years (may omit echocardiography) | Assess every 2 to 5 years | May consider every 5 years | Assess every 2 years | Promotion counseling at every visit; restrict contact; self-limit | Precautions for contraception and pregnancy |
* Includes history, physical examination, echocardiography, and electrocardiography.
¶ May include stress echocardiography, stress electrocardiography, stress with magnetic resonance perfusion imaging, and stress with nuclear medicine perfusion imaging.
Δ General healthy lifestyle counseling should be provided at every visit (may be performed by primary care provider).
◊ Restrictions for contact apply to patients on anticoagulation or dual antiplatelet therapy; self-limit refers to allowing patients to participate to their reasonable abilities without coercion or pressure to perform or overexert (self, parents, coaches).آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
