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Tissue plasminogen activator in pediatric myocardial infarction
S Krendel1, P Pollack, J Hanly
1Department of Emergency Medicine, University of Massachusetts Medical Center, Worcester, MA, USA.
Annals of Emergency Medicine
|April 28, 2000
Summary
Acute myocardial infarction is rare in children but can occur with Kawasaki disease. Intravenous tissue plasminogen activator successfully treated a child with a thrombosed coronary aneurysm causing heart attack.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Research
- Emergency Medicine
Background:
- Acute myocardial infarction (AMI) is uncommon in pediatric populations.
- Kawasaki disease is a leading cause of acquired heart disease in children and can lead to coronary artery aneurysms and thrombosis.
- Coronary artery thrombosis in children can precipitate AMI, presenting a diagnostic and therapeutic challenge.
Observation:
- A 7-year-old child presented with symptoms suggestive of acute myocardial infarction.
- Cardiac evaluation revealed a thrombosed coronary aneurysm as the cause of the myocardial infarction.
- This presentation is exceedingly rare in pediatric emergency medicine.
Findings:
- The case details the successful administration of intravenous tissue plasminogen activator (tPA) in a pediatric patient with AMI secondary to a thrombosed coronary aneurysm.
- This represents the first reported instance of using tPA for this specific clinical scenario in a child.
- The treatment resulted in successful reperfusion and management of the acute cardiac event.
Implications:
- Intravenous tissue plasminogen activator may be a viable therapeutic option for pediatric acute myocardial infarction caused by coronary artery thrombosis.
- This case expands the understanding of Kawasaki disease complications and treatment strategies.
- Highlights the importance of considering rare cardiovascular emergencies in pediatric patients presenting with cardiac symptoms.