Brief Answer: Infective endocarditis or Kawasaki disease Detailed Answer: Myocardial infarction is quite rare in such a young child; the two most common instances though would be an embolic event from infectious endocarditis, which is an infection of the heart and vales or Kawasakis's disease, also an infectious condition associated with an coronary aneurysm that can rupture. Hope that helps, wish you the best, Dr Brenes-Salazar MD Mayo Clinic MN Cardiology

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Brief Answer: See below Detailed Answer: Dear XXXXXXX : Thanks for the follow up questions. Here is a relatively simple explanation of those entities: Infective endocarditis: it is literally an infection in the heart that most commonly involves the valves and the inner surface, but can also extend to the inner muscle creating pus pockets called abscess. Usually caused by bacteria, most commonly bacteria from the mouth. The bacteria form clumps called vegetations, and these fragments if dislodged from a valve, particularly the main valve of the heart or aorta, can go into the coronary arteries, the ones that feed the heart, and cause a block. Quite rare but can happen Kawasaki disease: now we know that it is an inflammatory condition of the vessels, mainly small and medium size arteries, of unknown cause. It is also called mucocutaneous glandular syndrome, because kids get fever, blood shot eyes, peeling and cracking of the lips and skin, and "lumps" or swollen glands in the neck. Because it affects arteries, it can affect again the coronary arteries of the heart, causing a blockage or typically rupture, with catastrophic consequences. Again those would be the 2 main scenarios of a heart attack in a child; the other one, rare, and could be proven in autopsy, is a congenital abnormality of the coronary arteries, usually presents with sudden death Hope that helps, Dr Brenes-Salazar MD

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