Coronary Artery Vasospasm with Acute Myocarditis in an Adolescent

ABSTRACT

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.