Vasospastic angina in Kawasaki disease.

We report vasospastic angina in a young female with a history of Kawasaki disease (KD). She had had KD at the age of 20 months. Selective coronary angiograms at the age of 4 years revealed no coronary aneurysms or stenosis. She remained symptom-free for 29 years, but coronary angiograms at the age of 31 years revealed a localized 50% stenosis of the left anterior descending artery. Aging in addition to endothelial dysfunction of the coronary arterial wall resulting from acute KD vasculitis may underlie the late development of angina. This is the first case which is reported as vasospastic angina after KD. The occurrence of acute coronary syndromes in patients with a history of KD should be investigated carefully from now on. Attention should be paid to coronary endothelial dysfunction after KD in adults.