Though rare, myocardial ischemia in children can be devastating. For this reason, clinicians must recognize, diagnose, and manage myocardial ischemia early, especially for children at high-risk.

After completing this article, readers should be able to:

  1. Recognize the diverse clinical presentations of myocardial ischemia in children.

  2. Distinguish the pathophysiologic mechanisms of myocardial ischemia and use the appropriate investigational studies to confirm the diagnosis.

  3. Promptly start medical and/or surgical treatment of the underlying cause of the myocardial ischemia to prevent acute and long-term morbidity and mortality.

Myocardial ischemia in children is very rare. The exact prevalence cannot be determined accurately due to the multiple congenital and acquired pathophysiologic mechanisms that can lead to ischemia in children. Myocardial ischemia has a broad spectrum of clinical manifestations, including but not limited to chest pain, failure to thrive, cardiac arrest, and other causes. Failure in recognition, or delay in diagnosis, of ischemia may have very...

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