Coronary artery aneurysms due to childhood Kawasaki disease

Case contributed by Dr Craig Hacking

Presentation

Anterior ischaemia on ECG.

Patient Data

Age: 20-25 years
Gender: Female

CTCA

Coronary arteries:

Origins: Normal although the RCA arises from between the right and non coronary sinuses.

Dominance: Right

Left Main Coronary Artery (LMCA): Normal.

Left Anterior Descending (LAD): fusiform aneurysm in the proximal segment which is difficult to adequately assess given the artefact. It is irregular, 17 mm long and 6 mm in diameter with mural calcification proximally. Mild non opacification in the proximal portion of the aneurysm is suspicious for thrombosis.

D1, D2 - Patent

Circumflex artery (Cx): Normal.

1st obtuse marginal branch (OM1) - Patent

Intermediate artery (Ix): large vessel, normal.

Right Coronary Artery (RCA): 2 fusiform aneurysms without thrombosis- 1) proximal segment 15 mm long and 8 mm in diameter with mural calcification and 2) mid segment 7 mm long and 6.5 mm in diameter at the origin of a small AM branch.

Posterior descending artery (PDA) - Patent

Posterior left ventricular branch (PLV) - Patent

Cardiovascular Findings:

No LV myocardial thinning or fatty metaplasia.

Other Findings

Incidental 1.5cm segment 8 arterially enhancing lesion.

Conclusion

LAD and RCA aneurysms. No stenotic disease evident.

Case Discussion

Further Hx is of Kawasaki disease since 3 months of age. Anterior infarct from LAD thrombosis at 8 months.

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Case information

rID: 35218
Case created: 27th Mar 2015
Last edited: 15th Sep 2017
Systems: Vascular, Cardiac
Inclusion in quiz mode: Included

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