Children rarely present to emergency physicians during an acute myocardial
infarction. However, this may occur in the setting of Kawasaki disease with
thrombosed coronary aneurysms. We present the first case in which intraven
ous tissue plasminogen activator was used to successfully treat a 7-year-ol
d child having an acute myocardial infarction caused by a thrombosed corona
ry aneurysm.