Myocardial infarction (MI) is relatively infrequent in infants and children, although its association with anomalous origin of the left coronary artery and other congenital cardiac anomalies that result in coronary hypoperfusion is well known.1
Although MI has also been reported in some congenital heart defects without coronary artery abnormalities,2-4 massive MI of the left ventricle in tetralogy of Fallot (TOF) has not, to our knowledge, been reported.
Report of a Case.—An 8-month-old girl had been followed up elsewhere with the clinical diagnosis of TOF. Although moderately cyanotic, she had no history of hypoxic spells. On the morning of admission, she had an hypoxic spell. Because of poor response to conventional therapy, ie, knee-chest position, sodium bicarbonate, and morphine, she was transferred to our institution. On arrival, she was cool and blue-gray; heart rate was 150 beats per minute; respirations, 80/min; and blood pressure, 60/40 mm Hg. There