Incomplete Kawasaki disease presenting with abdominal pain diagnosed by echocardiography

A 4-year-old boy without any medical history presented to local emergency department with fever for 10 days and aggravated abdominal pain for 3 days. Gastroenteritis was suspected and intravenous antibiotic was prescribed. Three days later, he suffered cardiac arrest and after successful cardiopulmonary resuscitation, he was immediately transferred to our hospital. Electrocardiogram showed sinus tachycardia, Q wave was observed in V2-4 (Fig. 1a). Transthoracic echocardiogram (TTE) and 3-dimensional TTE revealed giant dilatation of left anterior descending coronary artery (LAD; 16 mm) with massive intraluminal thrombus (Fig. 1b, Video 1, 2), dilated right coronary artery (RCA; 6 mm), enlarged left ventricle with abnormal wall motion (left ventricular ejection fraction: 48%) (Fig. 1c, Video 3). Patient was diagnosed with incomplete Kawasaki disease and myocardial infarction. Intravenous immunoglobulin, clopidogrel, warfarin, and diuretic were administered.