A Giant Coronary Aneurysm in a Suspected Kawasaki Disease Causing Asymptomatic Myocardial Ischemia

Figures

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  Fig. 1. ( A ) Chest X-ray showing right heart border bulging suggestive of paracardiac mass; ( B, C ) transthoracic echocardiogram basal short axis showing huge aneurysm just after origin of right coronary artery (RCA) abutting right atrium (RA) with color flow seen into the mass from RCA; ( D ) basal short axis showing hyperechogenic inferior and inferoseptal wall suggesting ischemic changes; ( E ) apical 5 chamber view showing huge mass abutting RA.

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  Fig. 2. ( A, B ) Cardiac computed tomography showing huge right coronary aneurysm (67 × 69 mm) just after origin; ( C ) Contrast magnetic resonance imaging showing huge right coronary artery (RCA) aneurysm, distal RCA can also be seen distal to the aneurysm; ( D, E ) 15 minutes Late gadolinium scan showing subendocardial delayed enhancement in inferior and inferoseptal wall suggesting ischemia.

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  Fig. 3. ( A, B ) Angiogram showing right coronary artery giant aneurysm just after origin, distal vessel likely filling normally, note the posterior descending artery aneurysm near crux (arrow); ( C, D, E ) Different angiographic view showing large left main coronary artery bifurcation aneurysm at point of confluence.