Figure 9

An 11 year-old boy presented to a pediatric hospital with chest and jaw pain while playing one year after a prolonged febrile illness . Initially, CT angiography was performed (A, image courtesy of Dr. Christopher Learn) that showed thrombus in a calcified aneurysm of the left anterior descending coronary artery (LAD, arrow). In the setting of elevation of the serum troponin and possible need for coronary intervention, the patient was transferred to a nearby adult hospital. Invasive angiography (B) showed thrombus nearly occluding LAD that was treated with angioplasty and stent placement. C. Coronary MRA performed in another patient with KD using a navigator-triggered slab prescribed perpendicular to the aortic root demonstrates a 9 mm proximal LAD aneurysm (arrow). LV = left ventricle Ao = aorta.