Giant coronary aneurysm in adult Kawasaki disease: angiographic, 64-slice coronary MDCT and cardiac MRI appearances.
BACKGROUND
Kawasaki disease is a small-to-medium-vessel vasculitis that preferentially affects infants and young children. This condition is rare in adults, and therefore the diagnosis can easily be missed in a patient presenting to a primary care clinic. We report an unusual case of a patient who presented with ventricular fibrillation on a background of adult Kawasaki disease.


OBJECTIVE
To identify the advantages of using coronary multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging (MRI) in diagnosing adult Kawasaki disease.


METHODS
We studied a 52-year-old patient with Kawasaki disease using coronary angiography, cardiac MDCT and MRI.


RESULTS
Invasive coronary angiography demonstrated an occluded right coronary artery (RCA) and appearances suspicious for a calcified giant RCA aneurysm. The full extent of the aneurismal RCA was depicted with MDCT. Cardiac MRI revealed a chronic inferior segment myocardial infarction representing an arrhythmia substrate.


CONCLUSIONS
Our case highlights the increasing utility of contrast-enhanced cardiac MRI and MDCT in the diagnosis of this rare condition in adults.
Martos
R
R
Cardiac CT/MRI Program, Department of Cardiology, St. Vincent's University Hospital, Dublin, Ireland. ramonmartos2003@yahoo.co.uk
Walsh
S
S
McCreery
C
C
Dodd
J D
JD
D003323:Coronary Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology; D017023:Coronary Angiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000000981:diagnostic imaging*; D061330:Multidetector Computed Tomography