Management of myocardial infarctus in children

Background Myocardial infarction is usually the preserve of the elderly but is not exceptional in children. Different and numerous are its etiologies in the child. This clinical entity is little explored around the world. Purpose The objective of our study is to describe the clinical, paraclinical, etiologies and management of children presenting for STEMI. Methods It was a monocentric, retrospective, and descriptive study of children, registered from our cardiology department who were hospitalised for the management of an STEMI between 2010 and 2017. For each patient, medical record, transthoracic echography (TTE) report, biological reports and the coronarography report were analysed. Results We counted 7 cases; the average age was 12.87 years (from 4 to 17 years). All the kids in our study were boys. Two children were followed in paediatrics the first for KAWASAKI disease, the other for familial hypercholesterolemia. The common reason for consultation was anginal chest pain. Positive diagnosis was focused on the ECG. The most affected territory was the anterior in 57.14%. Infarction was complicated in two patients. The etiology of STEMI was variable from child to others; there was no etiology more common than others. TTE was performed before coronarography in all children; it identified the etiology in three children (the myxoma of the left atrium(LA), coronary birth anomaly, and KAWASAKI disease's by visualizing dilatation of coronaries and thrombus of the LAD). Coronarography was performed in all except for the child who had a myxoma of the LA. Only two children had tenecteplase thrombolysis. Two children were treated by angioplasty. Evolution: Only one child was dead after one year. Conclusion Although the STEMI in children is rare, but it must be evoked and perform an ECG in any child who consults for chest pain. TTE is essential in children. Management is broadly in line with that of adults because of the need to repeal the guilty artery, in addition to etiological treatment.