Heart attacks in children are a rare but under-recognised problem, according to a report from Ohio doctors documenting nine cases over 11 years in kids as young as 12.
All lacked common risk factors for heart problems, such as obesity, family history, high blood pressure, unhealthy cholesterol levels and drug abuse.
The cause of their heart attacks was most likely a heart spasm that briefly cut off blood supply, said Dr. John Lane, who wrote the report with colleague Dr. Giora Ben-Shachar of the Akron Children's Hospital in Akron, Ohio. The spasm is also a rare cause of heart attacks in adults.
Lane called it "an under-appreciated phenomenon." His report appears in October's issue of the medical journal Pediatrics.
All the children were stricken between 1995 and 2006, and most were treated at the Akron hospital. Lane treated a few of the earlier patients when he was at Rainbow Babies and Children's Hospital in Cleveland.
All but one of Lane's patients were boys. Doctors are uncertain whether girls face a lower risk because there is little in medical literature about this type of heart attack.
Chest pain is a common symptom in children, but 95 per cent of the time, it is not heart-related and it is rarely life-threatening, said Dr. Reginald Washington, a children's heart specialist.
Muscle strains and stress are among common causes of kids' chest pain. Most heart-related chest pain in kids is caused by infections, structural abnormalities or problems other than heart attacks, Washington said.
He said the Akron doctors' report "does a good job of telling physicians" they should not dismiss heart attack as a possibility in children.
Lane said parents should consult a doctor any time a child has sudden chest pain. A heart attack in children is typically a crushing-type pain that radiates to the arm, jaw or neck - similar to adults' symptoms, Lane said.
It is uncertain what causes spasm-related attacks, which do not involve the issues usually seen. ( Gulf )