Acute Myocardial Infarction with Multiple Giant Coronary Artery Aneurysms in a Juvenile with Kawasaki Disease

Coronary artery aneurysm (CAA), the most risky late complication of Kawasaki disease (KD), is associated with severe adverse cardiac events, such as acute myocardial infarction (AMI), in young patients. Herein, we describe a 16-year-old boy who suffered from occasional angina attack after a recent myocardial infarction due to multiple giant CAAs during the asymptomatic period of KD. Coronary angiography (CAG) revealed multiple large CAAs of about 9 mm in diameter at the left anterior descending artery (LAD) and more than 12 mm at the left circumflex coronary artery (LCX). To optimize the management and reduce the morbidity and mortality of giant CAAs, it is imperative to consider antecedent KD at the earliest possible stage, particularly in young patients with angina pectoris or AMI but lacking traditional risk factors for atherosclerosis. Long-term follow-up with an electrocardiogram (ECG), echocardiogram, or coronary computed tomography angiography (CCTA) is essential and should not be overlooked. In addition, this case highlights the great significance of working out a more comprehensive and effective management strategy for such KD juveniles, including drugs, percutaneous coronary intervention (PCI) or even surgery.