CTICasesPresumed Kawasaki Disease with Coronary Aneurysms
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Imaging findings
A chest radiograph revealed a pneumothorax and subtle calcification overlying the heart, better visualized on the lateral projection. Coronary CTA demonstrated multiple coronary aneurysms, some calcified, with the largest one affecting the left anterior descending artery, containing a significant focus of calcification and thrombus. The right coronary artery appeared dilated and ectatic, but the aortic root and valve were normal.
Key takeaways
Kawasaki disease, an acquired vasculitis, can lead to coronary aneurysms that may calcify and harbor thrombus, potentially causing stenosis. Clinical presentation, especially in children, often guides the diagnosis, as pathological differentiation from other vasculitides can be challenging. A marfanoid habitus (tall stature, pectus) can be coincidental and does not necessarily indicate Marfan syndrome, as genetic testing can differentiate.
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