Traversing the labyrinth: multimodality imaging of Kawasaki disease with saccular coronary artery aneurysms

Kawasaki disease (KD), an acute vasculitis of childhood, is the leading cause of acquired heart disease in developed countries with approximately 25% of untreated cases resulting in coronary artery aneurysms (1). Treatment during the acute phase with intravenous immunoglobulin (IVIG) and aspirin reduces the prevalence of coronary artery abnormalities; long-term management with thromboprophylaxis, beta blockers, statins, or surgical coronary artery bypass is determined based on coronary Z score, response to treatment, and evidence of myocardial ischemia throughout surveillance (2). The presented case highlights the severe complications of KD, necessity of multimodality imaging, and long-term management in high-risk patients.