Coronary artery aneurysms and myocardial infarction: adult sequelae of Kawasaki disease?

SUMMARY Coronary artery aneurysms developed in a 43 year old man who had suffered an acute myocardial infarction at the age of 30. In childhood he had had an illness that was consistent with Kawasaki disease, and it is suggested that the proximal discrete aneurysms and myocardial infarction may be the adult sequelae of this. The arteriographic appearance of a coronary artery aneurysm is of localised dilatation of the vessel between two segments that are of normal calibre. Coronary artery aneurysms are not uncommon: they were found in 14 % of necropsies performed in patients over the age of 16 years.1 They are usually arteriosclerotic in origin,2 but may be congenital, occur after injury, dissection, or infection, or be caused by polyarteritis nodosa. Mycotic and syph-ilitic coronary aneurysms are well described but more recently an additional possibly infective sourc