Multivessel giant coronary artery aneurysms in an adult with an acute coronary syndrome: Latent finding of Kawasaki disease

We present a case of a patient with an acute coronary syndrome who had the exceptionally rare finding of multivessel giant coronary artery aneurysms (>8 mm) involving the left main and ostial right coronary arteries with concomitant atherosclerotic disease. A work-up to diagnose medical conditions that would predispose the patient to giant coronary aneurysms was negative; however, a detailed history recalled a childhood hospitalization with a constellation of signs and symptoms consistent with Kawasaki disease. This demonstrates an unusual anatomy underlying a common cardiac presentation in adults that has implications for the management of the associated atherosclerotic coronary artery disease.