An adolescent with chest pain-sequela of Kawasaki disease

Kawasaki disease, is an acute vasculitis of unknown etiology characterized by mucocutaneous involvement occurring in infants and young children, predominantly younger than 5 years of age. We present a case of a 19-year-old female with a prior history of Kawasaki disease as an infant who was seen in the emergency department with chest pain in the midsternal region lasting for 20 minutes with radiation to the left arm. An electrocardiogram revealed anterior repolarization abnormalities with normal echocardiogram (ECHO) findings. There was a 90% eccentric and calcified single discrete stenosis of the proximal segment of the left anterior descending artery, and the patient underwent a successful percutaneous transluminal coronary angioplasty with stent insertion. Physicians working in the emergency department setting should remain cognescent of the rarer but significant cardiac causes of chest pain while evaluating children, adolescents, and young adults.