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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
PubMed

Insights

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.

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