Coronary artery aneurysms in Kawasaki disease most frequently arise in which segment?

• A Proximal left anterior descending artery ✓
• B Proximal right coronary artery only
• C Distal circumflex artery
• D Posterior descending artery

Explanation

Aneurysms show a strong predilection for the proximal segments of the major coronaries, and the proximal left anterior descending artery is the single most common site, followed closely by the proximal right coronary artery. This distribution explains why standard echocardiographic surveillance protocols focus measurements and z scores specifically on these proximal segments. Distal and branch vessel involvement occurs mainly in severe, diffuse disease.

Reference: Nelson Textbook of Pediatrics, 21st ed.

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