Activity guidelines for the older Kawasaki patient depend upon the level of risk determined by the patient's physician. For the majority of patients, no restrictions will apply.

For those patients with persistent coronary aneurysms, annual examination by a pediatric cardiologist, with an echocardiogram and electrocardiogram, is recommended. Stress testing with myocardial perfusion imaging maybe necessary every two years. If the stress test reveals deprivation of oxygen to the heart muscle (myocardial ischemia), then coronary angiography should be performed.

Patients with large or multiple coronary aneurysms and/or with obstruction of the coronary arteries should undergo annual stress tests, which will help determine safe levels of activity. Contact sports should be avoided - especially by those patients taking anti-coagulants because of the risk of bleeding. However, regular physical activity within safe levels should be pursued and a sedentary lifestyle should be avoided.

Anyone with congenital heart disease, repaired or non-repaired, should consult with their cardiologist about physical activity to review the risks.