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Case Reports

Symptomatic Coronary Obstruction Due to Kawasaki Disease in an Adult

^a Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas
^b Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas

Accepted for publication August 14, 2007.

^_* Address correspondence to Dr Conner, Department of Surgery, Cardiothoracic Surgery Service, 3851 Roger Brooke Dr, Fort Sam Houston, TX 78234 (Email: william.conner{at}amedd.army.mil).

Kawasaki disease is the most common cause of pediatric ischemic heart disease in the world, but it is unusual in adults. We present a case of Kawasaki disease in a young adult. This 20-year-old man presented with angina. Coronary angiography revealed aneurysmal obstructive lesions consistent with remote Kawasaki disease. The patient underwent coronary artery bypass grafting with arterial conduits. Postoperative echocardiography was normal and stress myocardial perfusion imaging showed no ischemia. He remained asymptomatic 12 months after surgery. There is controversy regarding optimal therapy, choice of conduit, treatment of proximal aneurysms, and surveillance in adults with Kawasaki disease.