This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kobayashi, T. Articles by Kobayashi, T. Search for Related Content PubMed PubMed Citation Articles by Kobayashi, T. Articles by Kobayashi, T.

(Circulation. 1998;98:92-93.)
© 1998 American Heart Association, Inc.

Images in Cardiovascular Medicine

Giant Coronary Aneurysm of Kawasaki Disease Developing During Postacute Phase

Tomio Kobayashi, MD; Katsuhiko Sone, MD; Makoto Shinohara, MD; Takashi Kosuda, MD; ; Toshihiro Kobayashi, MD

From the Department of Cardiology, Gunma Children's Medical Center, and the Department of Pediatrics, Gunma University School of Medicine (Toshihiro Kobayashi), Gunma, Japan.

Correspondence to Tomio Kobayashi, MD, The Department of Cardiology, Gunma Children's Medical Center, 779 Hokkitsu, Gunma 377, Japan.

The patient suffered from Kawasaki disease at 5 months of age. The first angiography, performed 14 months after the onset of disease, showed a right coronary aneurysm with a maximal diameter of 6 mm and normal left coronary artery (Figure 1). Dipyridamole and propranolol were given as antiplatelet therapy and for reduction of myocardial oxygen consumption, respectively. The second angiography, performed 6 years later, revealed enlargement of the right coronary aneurysm, with a maximal diameter of 15 mm (Figure 2). Treatment with dipyridamole and propranolol was continued. Ten years later, when the patient was 17 years old, the chest radiograph showed bulging of the right cardiac border. MRI demonstrated a giant coronary aneurysm (Figure 3). The findings of the ECG did not indicate myocardial ischemia. The third angiography, performed at 18 years of age, showed a giant right coronary aneurysm with a maximal diameter of 86 mm and normal left coronary artery (Figure 4). Because of the imminent risk of rupture, aortocoronary bypass with saphenous vein graft and aneurysmectomy were performed. Pathological studies of the coronary aneurysm showed marked intimal thickening due to fibrocellular proliferation, disappearance of the elastica interna, and thickening of the media (Figure 5).

View larger version (137K): [in this window] [in a new window]   Figure 1. First angiography shows right coronary aneurysm with a maximal diameter of 6 mm.

View larger version (153K): [in this window] [in a new window]   Figure 2. Second angiography, performed at 7 years of age, shows enlargement of right coronary aneurysm, with a maximal diameter of 15 mm.

View larger version (114K): [in this window] [in a new window]   Figure 3. MRI (spin-echo image) shows giant coronary aneurysm compressing . . . [Full Text of this Article]

This article has been cited by other articles:

				A KHOSITSETH, S SIRIPORNPITAK, R PORNKUL, and S WANITKUN Giant coronary aneurysm caused by Kawasaki disease: follow-up with echocardiography and multidetector CT angiography Br. J. Radiol., April 1, 2008; 81(964): e106 - e109. [Abstract] [Full Text] [PDF]

				E Tsuda, T Kamiya, Y Ono, K Kimura, and S Echigo Dilated coronary arterial lesions in the late period after Kawasaki disease Heart, February 1, 2005; 91(2): 177 - 182. [Abstract] [Full Text] [PDF]

				G. F. Greil, M. Stuber, R. M. Botnar, K. V. Kissinger, T. Geva, J. W. Newburger, W. J. Manning, and A. J. Powell Coronary Magnetic Resonance Angiography in Adolescents and Young Adults With Kawasaki Disease Circulation, February 26, 2002; 105(8): 908 - 911. [Abstract] [Full Text] [PDF]