ArticleJACC. Case reports2025
Missed Kawasaki Disease Mimicking as a Giant Coronary Aneurysm Mimicking an Intracardiac Mass.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundKawasaki 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.
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