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Missed Kawasaki Disease Mimicking as a Giant Coronary Aneurysm Mimicking an Intracardiac Mass

Year: 2025

Type: article

Abstract: BACKGROUND: Kawasaki disease with giant coronary aneurysms mimicking an intracardiac mass is an uncommon diagnosis in adult patients. CASE SUMMARY: A 56-year-old man with chronic chest pain syndrome presented with a sudden onset of weakness. Evaluation for a stroke revealed a large mass in the right atrium that measured approximately 2.2 cm × 2.0 cm immediately above the tricuspid valve annulus and adjacent to the atrioventricular groove on transthoracic echocardiography. Cardiac magnetic resonance ruled out an intracardiac mass, but instead demonstrated a right coronary artery (RCA) fusiform aneurysm. Coronary computed tomography angiography characterized this finding as 2 fusiform RCA aneurysms. Left-sided heart catheterization confirmed this diagnosis. DISCUSSION: Giant coronary aneurysms appearing as large, space-occupying intracavitary cardiac masses are rarely diagnosed. Escalating multimodal imaging is essential for accurate diagnosis and surgical planning. TAKE-HOME MESSAGES: Kawasaki disease can have a late presentation and should be considered in the differential diagnosis of coronary aneurysms. A multimodal imaging approach is essential for accurate diagnosis and management of giant coronary aneurysms.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.103763

Authors: Khalid Shakfeh, Mohamed Abdul Qader, Mohamad Hekmat Sukkari, Abhinav Karan, Emil Missov, Gladys Velarde

Institutions: University of Florida, East Carolina University

Language: English

Topic: Kawasaki Disease and Coronary Complications

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850