Giant coronary aneurysm and bivalvular insufficiency in severe Kawasaki disease: a case report

We report a case of severe Kawasaki disease with giant coronary artery aneurysms, multiple systemic arterial aneurysms, and delayed-onset, independently progressive bivalvular insufficiency due to direct valvulitis. Despite controlled inflammation and favourable coronary evolution under immunosuppressive therapy, the patient required surgical valve repair. This case highlights the unpredictable nature of complex Kawasaki disease phenotypes and underscores the need for comprehensive vascular imaging and lifelong follow-up, as atypical features may lead to independent complications.