Precordial pain and electrocardiographic abnormalities simulating myocardial infarction associated with increased intracranial pressure in a child.

Precordial pain associated with ECG ischemic pattern is a very rare phenomenon in children. Such findings were observed in an 8-year-old boy concomitantly with clinical signs of increased intracranial pressure resulting from occlusion of a previously installed atrioventricular shunt. When the shunt was replaced, chest pain and the ECG abnormalities disappeared. This experience would warrant alertness to the possibility that clinical and ECG signs of myocardial ischemia and other characteristic ECG abnormalities, as an expression of increased intracranial pressure, may occur not only in adults, but also in children.