A rare case of Williams syndrome diagnosed at the age of 41 is documen
ted. The first subjective symptom was chest pain and the patient displ
ayed many other features in addition to severe supravalvular aortic st
enosis with a systolic gradient of 60 mmHg. The stenotic lesion had an
area of 0.5 cm(2), and was associated with dilated and tortuous coron
ary arteries. Extended aortoplasty was successfully performed and the
postoperative course has been excellent without any cardiac symptoms.
In spite of the severe cardiac lesions, this case had been largely asy
mptomatic and presented unusual features related to the diagnosis and
management of this syndrome in an adult. The pattern of abnormalities
found in this case suggested problems in relation to the calcitonin/ca
lcitonin gene related peptide (CGRP) and the elastin gene occurring in
embryonic organogenesis.