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The pediatric team felt it might be ACS, but on review of his prior ECGs, it was thought to be really unchanged from the 2 prior and more consistent with myocarditis. Echo does not necessarily differentiate acute MI from pericarditis: both may have wall motion abnormalities. See an examples of CT ischemia here.
It is seldom done in pediatric age group. They include myocardial ischemia, acute pericarditis, pulmonary embolism, external compression due to mass over the right ventricular outflow tract region, and metabolic disorders like hyper or hypokalemia and hypercalcemia. With proper precautions, risk can be reduced.
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