OMI in a pediatric patient? Teenagers do get acute coronary occlusion, so don ' t automatically dismiss the idea.

 Acute coronary syndrome in a pediatric patient?Written by Kirsten Morrissey, MD with edits by Bracey, Grauer, Meyers, and Smith An older teen was transferred from an outside hospital with elevated serum troponin and and ECG demonstrating ST elevations.  The patient was obese and had a medical history of only recurrent tonsillitis status post tonsillectomy and adenoidectomy but was otherwise healthy and fully vaccinated. He reported 1.5 days of chest pain that started as substernal and crushing in nature awakening him from sleep and occasionally traveling to right side of neck.  The pain was described as constant, worse with deep inspiration and physical activity, sometimes sharp. Reports occasional dizziness but no syncope, no recent illness, no recent fever, no trauma, no tick bites, no lower extremity swelling, no viral symptoms. He denied drug or alcohol use. He did have a family history notable for early CAD. An ECG was perfomed on arrival to our ED:  NSR with ST elevation II,III, aVF with reciprocal depression in aVLWould you refer this pediatric patient for emergent PCI?The workup at the transferring hospital yielded elevated troponin I at 18.1 ng/mL (ULN<0.01), borderline elevated D-dimer at 0.56 mgL, without any clinical evidence of an infectious process. Serum WBC and CRP,  platelet count were within normal limits, negative respiratory viral panel, and chest XR revealed no acute findings a...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs