A young male patient with no risk factors for atherosclerotic disease suffered from an acute myocardial infarction at the age of 22 years, and was subsequently found to have multiple coronary artery aneurysms by coronary angiography. The transthoracic echocardiography was unable to identify coronary anomalies, whereas the transesophageal approach did show aneurysmatic lesions of the left anterior descending artery. These could have been caused by a previous episode of Kawasaki disease, a pathological finding that should be considered in any young adult presenting with proximal discrete coronary artery aneurysms.
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