Giant coronary artery aneurysms in a 58-year-old

Area of Science:

• Cardiology
• Pediatric Rheumatology
• Vascular Medicine

Background:

• Giant coronary aneurysms are a potential long-term complication of Kawasaki disease.
• These aneurysms may not fully regress and can lead to significant cardiovascular issues later in life.
• Kawasaki disease, initially described as mucocutaneous lymph node syndrome, affects children and involves coronary arteritis.

Purpose of the Study:

• To report a case of giant coronary aneurysms in an adult patient presenting with heart failure.
• To discuss the implications of late-onset presentation of Kawasaki disease sequelae.
• To consider the historical prevalence of Kawasaki disease beyond its initial description.

Main Methods:

• Case report of a 58-year-old male.
• Clinical presentation included heart failure and a large secundum atrial septal defect (ASD).
• Review of the patient's medical history and diagnostic findings related to coronary aneurysms.

Main Results:

• The patient presented with giant coronary aneurysms, a large ASD, and heart failure at age 58.
• This presentation suggests the possibility of Kawasaki disease sequelae persisting into adulthood.
• The case indicates potential underdiagnosis or earlier prevalence of the disease.

Conclusions:

• Giant coronary aneurysms from Kawasaki disease can persist, calcify, or thrombose, leading to adult cardiovascular complications.
• This case highlights the importance of considering Kawasaki disease sequelae in adult heart failure patients.
• The findings suggest the disease may have been present in other regions before its formal description.