It is extremely rare, but a child can have a heart attack, especially if they have a congenital or acquired heart disease or have experienced chest trauma.

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A heart attack, which doctors also call acute myocardial infarction, is rare in childhood.

This article explores heart attacks and the potential causes, the warning signs and symptoms to look out for, and diagnosing them.

Although rare, there are several possible causes of a heart attack in childhood, such as:

Congenital heart disease

Congenital heart disease, or congenital heart defects, is an umbrella term for birth-related heart conditions. It affects around 1% of live births.

Children with a history of certain congenital heart defects are at higher risk than others for having a heart attack from the blockage of a coronary artery.

Anomalous origin of the left coronary artery

An example of congenital heart disease is the anomalous origin of the left coronary artery. This occurs when the heart and blood vessels are forming. The left coronary artery connects to the pulmonary artery instead of the aorta in the heart.

When the heart does not get enough blood from the coronary arteries, it begins to fail, similar to what occurs during a myocardial infarction or heart attack.

However, this is also a rare occurrence, comprising less than 1% of all congenital heart defects in children.

Acquired heart disease

Acquired heart conditions develop after birth. Below are some examples of conditions a child may develop.

Rheumatic heart disease

This is the most common type of acquired heart disease in children, affecting 33.4 million people in 2015.

Rheumatic fever can be a consequence of untreated strep pharyngitis or strep throat. However, it is uncommon in places where doctors readily treat strep throat with antibiotics.

If doctors do not treat rheumatic fever promptly, long-term heart damage, or rheumatic heart disease, may occur. Rheumatic heart disease weakens the valves between the chambers of the heart.

Kasawki disease

Kawasaki disease is another acquired condition that affects 9–20 in every 100,000 children under five years in the United States.

Kawasaki disease affects the coronary arteries due to acute inflammation and the formation of coronary artery aneurysms, which may cause a myocardial infarction.

The condition also causes fever to develop suddenly. Other symptoms include:

  • rash
  • irritation and redness in the whites of the eyes
  • irritation and inflammation of the mouth, lips, and throat
  • swollen lymph glands
  • edema, or swelling in the hands and feet

Other main acquired heart conditions in children are myocarditis, which refers to an inflammation of the heart muscle, and pericarditis, which is the inflammation of the sac that holds the heart.

Chest trauma

Research also considers blunt chest trauma, due to injury or an accident, as a rare cause of heart attack in children.

It is important to look for possible signs that children may be experiencing a heart attack or symptoms of another condition for prompt diagnosis and treatment.

If a parent or caregiver notices the following symptoms in their child, they should seek medical attention.

Newborn symptomsOlder children symptoms
feeding problemsfatigue
lack of interest in surroundingslack of appetite
skin palenesshypotension
tachypneaweak pulse
dyspnearhythm irregularity

Overlaps with other conditions

Heart conditions may be difficult to diagnose in children due to the complexity of the condition and its overlap with other symptoms.

Hypertrophic cardiomyopathy is a condition that causes the heart muscle and heart walls to become thick.

In some cases, the wall becomes so thick that it blocks blood flow out of the heart. Many people do not receive a diagnosis until adulthood, making it far less common, affecting 1 in 200,000 children. However, symptoms of hypertrophic cardiomyopathy can mimic those of a heart attack.

It is important to seek immediate medical attention if a child shows any of the above symptoms.

Unlike adults, chest pain is rarely a symptom of a heart attack in children. Chest pain accounts for around 6 in every 1,000 visits to a pediatric emergency room.

Common causes of chest pain that do not relate to heart conditions include:

According to the Centers for Disease Control and Prevention (CDC), the mRNA COVID-19 vaccine may cause myocarditis or pericarditis in children. Both conditions can cause chest pain as a symptom.

It is important to diagnose chest pain early to rule out heart conditions and ensure doctors can provide management and treatment methods.

A healthcare professional can assess a child using one of the following diagnostic tools.

  • Chest X-rays can determine if the heart has enlarged.
  • Electrocardiograms can assess heart rhythm.
  • Echocardiograms can check heart structure and function.
  • An exercise stress test can assess heart-lung function.

A more invasive test is a cardiac catheterization study. This involves a doctor inserting a catheter into the heart through one of the blood vessels in an arm or leg. The test aims to check for clogged arteries or an irregular heartbeat.

As the procedure requires an anesthetic, some children may experience side effects from this medication, such as nausea and vomiting. However, this is usually only in the short term. A child will need to stay in bed for the first two hours to reduce the risk of bleeding.

Once a child has had something to eat and drink, passed urine, and mobilized they will be able to go home. The cardiologist will discuss the results with a parent or caregiver.


Myocardial infarction is so rare in children, and the causes are so diverse, that doctors have adapted principles of adult treatments for children.

In recent years, alteplase has become the most common fibrinolytic drug in children.

Other treatments may include:

Additionally, doctors may recommend a coronary angioplasty, a procedure that widens blocked or narrowed coronary arteries. The hospital survival for adolescents without any underlying heart disease is excellent, and the need for surgical coronary artery intervention is uncommon.

There have been cases of children experiencing heart attacks, but they are rare. What causes them can range from congenital to acquired heart diseases.

It is always best to seek a diagnosis and medical attention if a parent or caregiver notices any warning signs or symptoms that their child is experiencing.