Table 3. Long-term treatment plan according to Z score system modified from the 2017 American Heart Association guideline [15]

	Frequency of Cardiology Assessment1)	Assessment for inducible myocardial ischemia2)	Low-dose aspirin	Anticoagulation (warfarin or low-molecular-weight heparin)	Dual antiplatelet therapy (aspirin + clopidogrel)
No involvement	May discharge between 4 wk and 12 mo	None	4–6 wk then discontinue	Not indicated	Not indicated
Dilation only	If decreased to normal, discharge between 4 wk to 12 mo; if persistent dilation, reassess every 2–5 y	None	Indicated until regression to normal	Not indicated	Not indicated
Small aneurysm, current or persistent	Assess at 6 mo, then yearly	Assess every 2–3 y	Indicated	Not indicated	Not indicated
Small aneurysm, regressed to normal to dilation only	Assess every 1–3 y (may omit echocardiography)	Assess every 3–5 y	May be considered	Not indicated	Not indicated
Medium aneurysm, current or persistent	Assess at 3, 6, and 12 mo, then every 6–12 mo	Assess every 1–3 y	Indicated	Not indicated	May be considered
Medium aneurysm, regressed to small aneurysm	Assess yearly	Assess every 2–3 y	Indicated	Not indicated	May be considered
Medium aneurysm, regressed to normal or dilation only	Assess every 1–2 y (may omit echocardiography)	Assess every 2–5 y	Reasonably indicated	Not indicated	Not recommended except in the presence of inducible myocardial ischemia
Large or giant aneurysm, current or persistent	Assess at 3, 6, 9, and 12 mo, then every 3–6 mo	Assess every 6–12 mo	Indicated	Reasonably indicated	May be considered in addition to anticoagulation3)
Large or giant aneurysms, regressed to medium aneurysm	Assess every 6–12 mo	Assess yearly	Indicated	Not indicated	Reasonably indicated
Large to giant aneurysm, regressed to small aneurysm	Assess every 6–12 mo	Assess every 1–2 y	Indicated	Not indicated	Not indicated
Large or giant aneurysm, regressed to normal or dilation only	Assess every 1–2 y (may omit echocardiography)	Assess every 2–5 y	Reasonably indicated	Not indicated	Not indicated

To include history and physical examination, echocardiography, and electrocardiography.
May include stress echocardiography, stress electrocardiography, stress with magnetic resonance perfusion imaging, and stress with nuclear medicine perfusion imaging.
May be considered in addition to anticoagulation in the setting of very extensive or distal coronary artery aneurysms, or if a history of coronary artery thrombosis.