Aortopexy Complicated by ST Segment Elevations in a Four-Month-Old Infant.

A four-month-old female infant presented for a thoracoscopic aortopexy for severe tracheomalacia. The case proceeded uneventfully until a specimen bag was introduced into the chest to remove the thymus. The child developed significant ST segment elevations in all 12 leads on electrocardiogram. An emergent intraoperative echocardiogram was performed but did not reveal any findings to account for the diffuse ST segment elevations. The ST segment elevations remained elevated for 48 hours following the procedure with no apparent hemodynamic instability or structural damage to the heart. Troponin levels returned to normal a few days later, and the child was discharged home without sequelae. The incidence of ST segment elevations in children without congenital heart disease is rare but can potentially lead to significant morbidity and mortality. This case report seeks to highlight the importance of swift recognition of ST changes in the pediatric population, discuss possible causes, and describe appropriate workup.