Cardiac ischemia in pediatric patients

Evaluating Chest Pain and Heart Murmurs in Pediatric and Adolescent Patients

Chest pain and heart murmurs are common issues primary care providers must evaluate and manage. Both are a source of anxiety for patients, parents, and providers, necessitating evaluation and understanding to ensure appropriate management. Most pediatric chest pain can be treated symptomatically and with reassurance. This article examines the approach to pediatric chest pain including identification of key historical points, common causes of chest pain, and when to refer. The article also delineates our approach to auscultation, describes common benign murmurs, and offers suggestions on when to refer for further evaluation.

Congenital Coronary Aneurysm: Unusual Presentation of Myocardial Ischemia in Children

Coronary artery aneurysms in children are usually associated with inflammatory disease such as Kawasaki disease or connective tissue disease. Congenital coronary aneurysm is a rare entity with few case reports published in the literature. We report an unusual case of congenital coronary aneurysm in an 11-year-old boy presented to our center with an ischemic cardiac event. Further investigations including computed tomography scan, cardiac magnetic resonance imaging, and coronary angiography revealed a large aneurysm arising from the proximal segment of left anterior descending (LAD) artery. Surgical repair was done including aneurysm resection and roofing the LAD artery using autologous saphenous vein patch.