Highlights that coronary artery spasm can occur as a rare complication of myocarditis in children, particularly those with Raynaud's phenomenon, and can be successfully managed with IVIG and calcium channel blockers.
Alerts clinicians to vasospasm in adolescents with myocarditis and Raynaud's; single case leaves optimal therapy open.
A 13-year-old boy had a 5-day history of prodromal symptoms of fever and dry cough followed by two episodes of severe anginal chest pain and substantial transient ST-segment elevation. A subsequent evaluation showed that the chest pain was caused by coronary artery vasospasm complicating acute myocarditis. We report a rare case of coronary artery vasospasm in an adolescent with a medical history of Raynaud's phenomenon who was successfully treated with intravenous immunoglobulin and a calcium channel blocker. This report exemplifies the need for pediatricians to be aware that anginal pain due to coronary artery spasm can, albeit rarely, occur in children as a complication of myocarditis, sometimes as a concomitant feature in patients with Raynaud's phenomenon; in suspected cases, serial electrocardiography is important to perform.
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Jung et al. (2020) studied this question.
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