**23. Treatment**

**20. Nephrotic syndrome**

**21. Antiphospholipid antibody syndrome**

great artery particularly have additional risks for MI [76].

the liver [73].

118 Myocardial Infarction

thematosus [4].

**22. Diagnosis**

gest a diagnosis of MI [14].

levels are important for diagnosis.

Nephrotic syndrome is a known condition which increases the tendency to thrombosis [71, 72]. Although the mechanism of the tendency to thrombosis is not completely known, it is thought that lipid abnormalities increase the tendency to thrombosis by increasing haemoconcentration and hypervolemia and the viscosity of full blood and plasma and that hypoalbuminemia stimulates the synthesis of fibronectin, fibrinogen and factors II, V, X, XI, from

Antiphospholipid antibody syndrome is a syndrome characterised by low antiphospholipid antibodies in the blood during pregnancy and arterial and venous thromboses [74, 75]. Just as antiphospholipid antibody syndrome can be seen isolated as primary antiphospholipid antibody syndrome, it may also be seen together with diseases such as systemic lupus ery-

When diagnosing MI in children it can be useful to request consultation from adult cardiologists experienced with MI. The anamnesis, laboratory tests and imaging methods should be used to full benefit in diagnosis. Even if the anamnesis does not have such a satisfactory role in Paediatric diagnosis as it does for adults, information must be obtained about the character and radiation of the pain, especially from school-age children and adolescents. The determination of CHD, previous surgical interventions because of the CHD in the anamnesis aortic stenosis, hypertrophic cardiomyopathy, patients underwent operation for transposition of

In the physical examination, the determination of weak pulse, dyspnoea, rhythm irregularity, sudden paroxysmal abdominal pain, gallop rhythm, cold extremities and shock should suggest MI [2]. The determination of PR segment depression on ECG, ST segment elevation together with the J point in at least two adjacent derivations, deep and/or wide Q-wave in at least one derivation, T-wave changes, ventricular arrhythmia and cardiac block should sug-

On echocardiography, segmentary wall movement abnormalities, a reduction in left ventricle functions, papillary muscle rupture and left ventricle free wall rupture are valuable for diagnosis [24, 77]. In the laboratory examination, elevation in troponin levels and increased CKMB

Coronary angiography is the standard diagnostic method for MI [35]. The application of coronary angiography should be considered in patients with high troponin levels and findings in the anamnesis suggestive of MI. It must also not be forgotten that coronary angiography in MI

cases related to vasoconstrictor substance intake, could be normal [63].

As there are no comprehensive studies related to PMI treatment, the treatment principles of adult MI treatments have been adapted for children and have been formed from experience focussed on cases. Treatment must be organised according to the aetiology and clinical status of the patient. To determine arrhythmia or for early intervention when it has been determined, ECG monitorisation should be applied as soon as possible to all patients with suspected MI [10, 23].
