Giant Coronary Aneurysms Caused by Kawasaki Disease

Abstract

An 8-year-old boy who presented to our hospital had all of the signs consistent with Kawasaki disease (KD; i.e., all criteria were met). He was treated with intravenous gamma globulins and oral acetylsalicylic acid. Transthoracic echocardiography showed a dilated left coronary artery (LCA) that was 15 mm in diameter. His platelet count was increased at 1.2 million/mm. The patient was well when he was discharged to home. There was no change in his echocardiogram on discharge. During the 6-month followup period, the child had no cardiac symptoms. A routine follow-up coronary angiography showed an 18 mm–wide coronary artery aneurysm (CAA) in the LCA. A few smaller aneurysms in the distal part of the left circumflex artery were also noticed (Fig. 1). The right coronary artery (RCA) was completely blocked (Fig. 2). Contrast medium, however, was visible distally in the RCA due to collateral flow. Discussion