The contribution of MR coronary angiography to the diagnosis of a left anterior descending artery aneurysm in a patient with Kawasaki disease

We present a 4-year-old boy with a diagnosis of Kawasaki disease of six-month history. At the time of diagnosis, no significant coronary artery aneurysm was detected by transthoracic echocardiography. On his routine follow-up echocardiography, dilatation of the left anterior descending (LAD) artery was suspected, but an exact diagnosis could not be made. He underwent magnetic resonance (MR) coronary angiography which showed a large fusiform aneurysmatic dilatation in the proximal segment of the LAD with a diameter of 9 mm. Coronary angiography performed to plan surgical repair confirmed the findings of MR angiography. The patient’s parents refused surgical repair, so antiplatelet therapy was started to prevent thrombosis. No complications occurred during seven months of follow-up after detection of the aneurysm.