Kawasaki disease primarily affects children below 5 years of age, and fatal coronary complications usually occur within 6-12 months following the acute illness. We report 2 unusual fatal cases of thrombosed coronary artery aneurysms. The first case was an 11-year-old boy, who died suddenly 2 months after the acute illness. He had a classical clinical picture, but was misdiagnosed. The second case was a 29-year-old man without history of recent febrile episodes or cardiac symptoms. Both subjects fulfilled the stage 4 criteria of Kawasaki disease (healing stage) with extensive old myocardial damage. The cases illustrate the great variation in the clinical picture of Kawasaki disease. Teenagers can also be affected, and extensive myocardial damage may be asymptomatic for many years.