Atherosclerotic coronary artery ectasia or adult mucocutaneous lymph node syndrome (Kawasaki's disease)?

We report the case of a 42 year old man, who was admitted to hospital with an inferior myocardial infarction. He was treated with tissue plasminogen a ctivator whithout complications in the acute phase. The stress testing perf ormed before discharge showed residual myocardial ischemia.A catheterizatio n study was indicated. The coronary angiogram demonstrated diffuse three ve ssel coronary artery aneurysmal disease. Two years before the patient had a n aneurysm of the right iliac artery being operated on. The differential di agnosis of adult aneurysmal coronary disease is discussed with emphasis on Kawasaki's disease and atherosclerotic coronary artery ectasia.