Congenital anomalies of coronary artery misdiagnosed as coronary dilatations in Kawasaki disease: A clinical predicament

Figure 1 Computed tomography coronary angiography images of patient 1, 2 and 3. A, C and E: Volume rendered; B: Curved reformatted images show separate origins of left anterior descending artery (thick arrows) and left circumflex (thin arrows) from left sinus with absent left main coronary artery. This was misinterpreted as dilated left main coronary artery on two-dimensional echocardiography; D: Axial images show a single coronary artery (thick arrows in C and D) with the normal course and caliber of left anterior descending artery (arrowheads) and left circumflex (thin arrows). Note the origin of right coronary artery from the left main coronary artery (long arrows in C and D) with inter-arterial course and main pulmonary artery- asterisk; F: Axial; G: Curved reformatted images show the origin of left main coronary artery (arrowhead in E; arrow in F) from the main pulmonary artery (asterisk). Note the dilated entire course of right coronary artery in the G and axial inset image.

Figure 2 2D echocardiography images in patient 2 and patient 3. A-C: Images show dilated left main coronary artery (thick arrows in A and B) with normal left anterior descending (arrowhead) and left circumflex (thin arrow in B) and normal proximal right coronary artery (thin arrows in C); D: Image shows dilated proximal right coronary artery in patient 3 (thick arrow).