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. 1991 Jun;65(6):332–336. doi: 10.1136/hrt.65.6.332

Myocardial infarction in childhood: clinical analysis of 17 cases and medium term follow up of survivors.

D S Celermajer 1, G F Sholler 1, R Howman-Giles 1, J M Celermajer 1
PMCID: PMC1024677  PMID: 2054243

Abstract

Between 1979 and 1989 17 patients aged two months to 12 years with acute myocardial infarction of any cause (other than after cardiac surgery) were seen at a children's hospital. Eight died from three days to three years after diagnosis (overall mortality 47%). The nine survivors, now aged 2-17 years, have been followed for one to 10 years (mean follow up five years) after infarction. The commonest causes of myocardial infarction in this series were anomalous origin of left coronary artery from the pulmonary artery (six patients (35%] and Kawasaki disease (five patients (27%]. The main symptoms of acute myocardial infarction were dyspnoea, vomiting, and difficulty feeding. Diagnosis was made in all patients by electrocardiography and confirmed by echocardiography, cardiac catheterisation, or at operation. All survivors were symptom free with excellent exercise capacity. The left ventricular ejection fraction in survivors ranged from 21% to 66%, and only one child was on regular cardiac medications. There were no cases of late sudden death. Twenty four hour Holter monitoring performed on survivors was normal (seven) or showed minor abnormalities only (one), suggesting that serious arrhythmia is rare after paediatric myocardial infarction. Myocardial infarction in children had a high early mortality; however, the incidence of serious arrhythmia was low in the survivors, who had a good exercise tolerance even when the left ventricular ejection fraction was low.

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Selected References

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  1. Adgey A. A., Allen J. D., Geddes J. S., James R. G., Webb S. W., Zaidi S. A., Pantridge J. F. Acute phase of myocardial infarction. Lancet. 1971 Sep 4;2(7723):501–504. doi: 10.1016/s0140-6736(71)90434-x. [DOI] [PubMed] [Google Scholar]
  2. Anderson S. D., Godfrey S. Cardio-respiratory response to treadmill exercise in normal children. Clin Sci. 1971 May;40(5):433–442. doi: 10.1042/cs0400433. [DOI] [PubMed] [Google Scholar]
  3. Bernstein D., Finkbeiner W. E., Soifer S., Teitel D. Perinatal myocardial infarction: a case report and review of the literature. Pediatr Cardiol. 1986;6(6):313–317. [PubMed] [Google Scholar]
  4. Bigger J. T., Heller C. A., Wenger T. L., Weld F. M. Risk stratification after acute myocardial infarction. Am J Cardiol. 1978 Aug;42(2):202–210. doi: 10.1016/0002-9149(78)90901-3. [DOI] [PubMed] [Google Scholar]
  5. Bigger J. T., Heller C. A., Wenger T. L., Weld F. M. Risk stratification after acute myocardial infarction. Am J Cardiol. 1978 Aug;42(2):202–210. doi: 10.1016/0002-9149(78)90901-3. [DOI] [PubMed] [Google Scholar]
  6. Bor I. Myocardial infarction and ischaemic heart disease in infants and children. Analysis of 29 cases and review of the literature. Arch Dis Child. 1969 Apr;44(234):268–281. doi: 10.1136/adc.44.234.268. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Brown N. J. Proceedings: Myocardial infarction in the newborn. Arch Dis Child. 1974 Jun;49(6):494–494. doi: 10.1136/adc.49.6.494-e. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Burtt D. M., Pollack P., Bianco J. A. Intravenous streptokinase in an infant with Kawasaki's disease complicated by acute myocardial infarction. Pediatr Cardiol. 1986;6(6):307–311. [PubMed] [Google Scholar]
  9. Courtemanche D. J., Firth C. E., Onyet H. Myocardial infarction in a child with Salmonella enterocolitis. Pediatr Cardiol. 1986;6(5):279–281. [PubMed] [Google Scholar]
  10. Cumming G. R., Friesen W. Bicycle ergometer measurement of maximal oxygen uptake in children. Can J Physiol Pharmacol. 1967 Nov;45(6):937–946. doi: 10.1139/y67-111. [DOI] [PubMed] [Google Scholar]
  11. GAULT M. H., USHER R. Coronary thrombosis with myocardial infarction in a newborn infant. Clinical, electrocardiographic and post-mortem findings. N Engl J Med. 1960 Aug 25;263:379–382. doi: 10.1056/NEJM196008252630803. [DOI] [PubMed] [Google Scholar]
  12. Jones F. L., Jr Transmural myocardial necrosis after nonpenetrating cardiac trauma. Am J Cardiol. 1970 Oct;26(4):419–422. doi: 10.1016/0002-9149(70)90740-x. [DOI] [PubMed] [Google Scholar]
  13. Josephson M. A., Brown B. G., Hecht H. S., Hopkins J., Pierce C. D., Petersen R. B. Noninvasive detection and localization of coronary stenoses in patients: comparison of resting dipyridamole and exercise thallium-201 myocardial perfusion imaging. Am Heart J. 1982 Jun;103(6):1008–1018. doi: 10.1016/0002-8703(82)90564-6. [DOI] [PubMed] [Google Scholar]
  14. KEITH J. D. The anomalous origin of the left coronary artery from the pulmonary artery. Br Heart J. 1959 Apr;21(2):149–161. doi: 10.1136/hrt.21.2.149. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Kahn J. K., Buda A. J. Long-term follow-up of coronary artery occlusion secondary to blunt chest trauma. Am Heart J. 1987 Jan;113(1):207–210. doi: 10.1016/0002-8703(87)90035-4. [DOI] [PubMed] [Google Scholar]
  16. Kato H., Ichinose E., Kawasaki T. Myocardial infarction in Kawasaki disease: clinical analyses in 195 cases. J Pediatr. 1986 Jun;108(6):923–927. doi: 10.1016/s0022-3476(86)80928-3. [DOI] [PubMed] [Google Scholar]
  17. Kato H., Ichinose E., Yoshioka F., Takechi T., Matsunaga S., Suzuki K., Rikitake N. Fate of coronary aneurysms in Kawasaki disease: serial coronary angiography and long-term follow-up study. Am J Cardiol. 1982 May;49(7):1758–1766. doi: 10.1016/0002-9149(82)90256-9. [DOI] [PubMed] [Google Scholar]
  18. Kegel S. M., Dorsey T. J., Rowen M., Taylor W. F. Cardiac death in mucocutaneous lymph node syndrome. Am J Cardiol. 1977 Aug;40(2):282–286. doi: 10.1016/0002-9149(77)90021-2. [DOI] [PubMed] [Google Scholar]
  19. Kilbride H., Way G. L., Merenstein G. B., Winfield J. M. Myocardial infarction in the neonate with normal heart and coronary arteries. Am J Dis Child. 1980 Aug;134(8):759–762. doi: 10.1001/archpedi.1980.02130200029010. [DOI] [PubMed] [Google Scholar]
  20. Kostis J. B., Byington R., Friedman L. M., Goldstein S., Furberg C. Prognostic significance of ventricular ectopic activity in survivors of acute myocardial infarction. J Am Coll Cardiol. 1987 Aug;10(2):231–242. doi: 10.1016/s0735-1097(87)80001-3. [DOI] [PubMed] [Google Scholar]
  21. LEVINE H. D., PHILLIPS E. An appraisal of the newer electrocardiography: correlations in one hundred and fifty consecutive autopsied cases. N Engl J Med. 1951 Nov 29;245(22):833–842. doi: 10.1056/NEJM195111292452201. [DOI] [PubMed] [Google Scholar]
  22. Leppo J., Boucher C. A., Okada R. D., Newell J. B., Strauss H. W., Pohost G. M. Serial thallium-201 myocardial imaging after dipyridamole infusion: diagnostic utility in detecting coronary stenoses and relationship to regional wall motion. Circulation. 1982 Sep;66(3):649–657. doi: 10.1161/01.cir.66.3.649. [DOI] [PubMed] [Google Scholar]
  23. Menahem S., Venables A. W. Anomalous left coronary artery from the pulmonary artery: a 15 year sample. Br Heart J. 1987 Oct;58(4):378–384. doi: 10.1136/hrt.58.4.378. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Nakano H., Saito A., Ueda K., Nojima K. Clinical characteristics of myocardial infarction following Kawasaki disease: report of 11 cases. J Pediatr. 1986 Feb;108(2):198–203. doi: 10.1016/s0022-3476(86)80982-9. [DOI] [PubMed] [Google Scholar]
  25. Norris R. M., Caughey D. E., Mercer C. J., Scott P. J. Prognosis after myocardial infarction. Six-year follow-up. Br Heart J. 1974 Aug;36(8):786–790. doi: 10.1136/hrt.36.8.786. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. PARMLEY L. F., MANION W. C., MATTINGLY T. W. Nonpenetrating traumatic injury of the heart. Circulation. 1958 Sep;18(3):371–396. doi: 10.1161/01.cir.18.3.371. [DOI] [PubMed] [Google Scholar]
  27. Radford D. J., Sondheimer H. M., Williams G. J., Fowler R. S. Mucocutaneous lymph node syndrome with coronary artery aneurysm. Am J Dis Child. 1976 Jun;130(6):596–598. doi: 10.1001/archpedi.1976.02120070022005. [DOI] [PubMed] [Google Scholar]
  28. Rein A. J., Colan S. D., Parness I. A., Sanders S. P. Regional and global left ventricular function in infants with anomalous origin of the left coronary artery from the pulmonary trunk: preoperative and postoperative assessment. Circulation. 1987 Jan;75(1):115–123. doi: 10.1161/01.cir.75.1.115. [DOI] [PubMed] [Google Scholar]
  29. Rigo P., Becker L. C., Griffith L. S., Alderson P. O., Bailey I. K., Pitt B., Burow R. D., Wagner H. N., Jr Influence of coronary collateral vessels on the results of thallium-201 myocardial stress imaging. Am J Cardiol. 1979 Sep;44(3):452–458. doi: 10.1016/0002-9149(79)90396-5. [DOI] [PubMed] [Google Scholar]
  30. Sharpe N., Murphy J., Smith H., Hannan S. Treatment of patients with symptomless left ventricular dysfunction after myocardial infarction. Lancet. 1988 Feb 6;1(8580):255–259. doi: 10.1016/s0140-6736(88)90347-9. [DOI] [PubMed] [Google Scholar]
  31. Sholler G. F., Yu J. S., Bale P. M., Hawker R. E., Celermajer J. M., Kozlowski K. Generalized arterial calcification of infancy: three case reports, including spontaneous regression with long-term survival. J Pediatr. 1984 Aug;105(2):257–260. doi: 10.1016/s0022-3476(84)80123-7. [DOI] [PubMed] [Google Scholar]
  32. Srivastava S. C., Chervu L. R. Radionuclide-labeled red blood cells: current status and future prospects. Semin Nucl Med. 1984 Apr;14(2):68–82. doi: 10.1016/s0001-2998(84)80022-7. [DOI] [PubMed] [Google Scholar]
  33. Sullivan W., Vlodaver Z., Tuna N., Long L., Edwards J. E. Correlation of electrocardiographic and pathologic findings in healed myocardial infarction. Am J Cardiol. 1978 Nov;42(5):724–732. doi: 10.1016/0002-9149(78)90090-5. [DOI] [PubMed] [Google Scholar]
  34. Tsukada K., Takemura N., Itoh K., Tatara K., Tahara K., Lee K., Kiguchi H., Kusakawa S. Myocarditis with myocardial infarction like findings in a 3-year old girl. Jpn Circ J. 1986 Dec;50(12):1275–1279. doi: 10.1253/jcj.50.1275. [DOI] [PubMed] [Google Scholar]
  35. Vouhé P. R., Baillot-Vernant F., Trinquet F., Sidi D., de Geeter B., Khoury W., Leca F., Neveux J. Y. Anomalous left coronary artery from the pulmonary artery in infants. Which operation? When? J Thorac Cardiovasc Surg. 1987 Aug;94(2):192–199. [PubMed] [Google Scholar]
  36. Wesselhoeft H., Fawcett J. S., Johnson A. L. Anomalous origin of the left coronary artery from the pulmonary trunk. Its clinical spectrum, pathology, and pathophysiology, based on a review of 140 cases with seven further cases. Circulation. 1968 Aug;38(2):403–425. doi: 10.1161/01.cir.38.2.403. [DOI] [PubMed] [Google Scholar]
  37. Wróblewska-Kałuzewska M., Wójcicka-Urbańska B. Przypadek zawału serca u 11-letniej dziewczynki w przebiegu zapalenia mieśnia serca. Pediatr Pol. 1986 Nov;61(11):735–739. [PubMed] [Google Scholar]
  38. Yanagisawa M., Kobayashi N., Matsuya S. Myocardial infarction due to coronary thromboarteritis, following acute febrile mucocutaneous lymph node syndrome (MLNS) in an infant. Pediatrics. 1974 Sep;54(3):277–280. [PubMed] [Google Scholar]
  39. de Moor M. M., Vosloo S. M., Human D. G. Myocardial infarction in a neonate with cyanotic congenital heart disease. Pediatr Cardiol. 1986;6(4):219–221. doi: 10.1007/BF02311003. [DOI] [PubMed] [Google Scholar]

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