Coronary artery aneurysms due to childhood Kawasaki disease

Case contributed by Craig Hacking
Diagnosis certain


Anterior ischemia on ECG.

Patient Data

Age: 25 years
Gender: Female


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.


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.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.