Ischemic heart disease 31 years after possible Kawasaki disease

We present a 38-year-old woman who had experienced an acute febrile illness lasting more than 1 week at the age of 6, with erythema on the palms and soles following skin desquamation in the subacute phase and skin eruption. Thirty one years later, she experienced acute myocardial infarction and episodes of angina pectoris. She had no coronary risk factors or autoimmune diseases. Coronary angiography revealed an aneurysm of the proximal left coronary artery with occluded lesions at the distal site. The right coronary artery was also occluded at the proximal site. These findings strongly suggest Kawasaki disease should be considered in the differential diagnosis of early-onset ischemic heart disease in young adults.