CTICasesKawasaki Disease with Coronary Aneurysms and Occlusions
Imaging findings
Coronary CT in a 14-year-old patient demonstrates diffuse coronary artery abnormalities including a very abnormal proximal right coronary artery (RCA) with alternating areas of enlargement and narrowing, a dilated conus branch, and a tortuous distal RCA. The left anterior descending (LAD) artery and proximal circumflex artery are completely occluded, with reconstitution of the more distal circumflex artery, which also shows an aneurysm with peripheral thrombus.
Key takeaways
Kawasaki disease, even years after presentation, can lead to severe coronary artery disease in pediatric patients, including aneurysms, occlusions, stenosis, and extensive collateral circulation. The appearance can be dramatic, with multiple segments affected. Imaging features can sometimes mimic fistulas, necessitating careful evaluation, potentially with catheterization.
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