Table 4.

Risk factors for an acute coronary syndrome in children.

1.	Factors That Increase the Vascular Turbulence in Coronary Arteries Coronary aneurysms (the risk increases with the diameter of the aneurysm) Coronary dilation after Kawasaki or Kawasaki-like disease Coronary stenosis After cardiac surgery, including the origin of the coronary arteries Thromboembolic events (embolization into a coronary artery) in endocarditis Coronary wall alterations secondary to chronic kidney disease
2.	Factors Associated with Reduced Myocyte Supply Heart Failure Hypotension Shock Systolic dysfunction Severe hypovolemia Severe anemia Severe hypoglycemia Severe cyanotic disease (oxygen saturation < 70–80%) Severe left heart obstructive disease-aortic stenosis, mitral stenosis, hypertrophic obstructive cardiomyopathy
3.	Primary Factors That Increase the Risk for Thrombosis Mutation of the Factor V Leiden Mutation of the prothrombin G20210A Mutation of factor XIII Deficiency in Protein C Deficiency in Protein S Deficiency in Antithrombin III Familial dysfibrinogenemia Congenital deficiency of plasminogen MTHFR mutation (homocysteine increased levels)
4.	Secondary Factors That Increase the Risk for Thrombosis Autoimmune disease-antiphospholipid syndrome, lupus anticoagulant, anticardiolipin antibodies, anti-beta 1 glycoprotein antibodies. Heparin-induced thrombocytopenia Thrombotic thrombocytopenic purpura Hemolytic-uremic syndrome Paroxysmal nocturnal hemoglobinuria COVID-19 Sepsis Sickle-cell disease Myeloproliferative disorders Essential thrombocytosis Policitemia vera Cancer Central venous catheter Nephrotic syndrome Membranous nephropathy Inflammatory bowel disease (ulcerative colitis, Crohn’s disease) Pregnancy Estrogen pills Obesity Sedentarism