PMC5397497_01
The coronary angiogram demonstrated proximal aneurysms and the extensive stenotic changes of the left (A) and the right coronary artery (B) caused by Kawasaki disease.
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F1
The angiogram revealed coronary aneurysms (6 mm in diameter), but the more important finding was the severity and the extent of stenotic lesions of all coronary arteries (Figure 1).
While waiting for heart transplantation, recurrent ischemic heart attacks were observed; exemplary electrocardiogram (day 14 on waiting list) showing significant ST depression in lead II, III, and aVF.
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F2
While waiting for transplantation, many ischemic episodes were documented (Figure 2).
Intra-operative view of the diseased heart with the extensive changes of the coronary arteries caused by Kawasaki disease. In front is the left anterior descending artery visible.
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F3
The coronary arteries resembled "chicken feet": thick, fibrotic, and sclerotic with proximal aneurysms (Figure 3).
(A) Cross-section of the proximal region of the left anterior descending artery showing the excessive thickening of the coronary artery wall at the level of aneurysm. (B) Multiple infarctions were presented in the left ventricular wall (arrows).
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F4
Transsections of explanted heart revealed severe thickening of the coronary arterial wall and multiple myocardial infarctions (Figure 4).