Myocardial infarctions (MI) have been reported in adults with COVID-19. Although 
MIs are rare in children with COVID-19, cardiac involvement is still possible. 
In this case report, we present an adolescent with recent COVID-19 infection who 
presented with an ECG initially suggestive of myocardial infarction (MI). We 
describe how to differentiate between myocardial infarctions and 
myopericarditis. A 15-year-old boy, with a history of COVID-19 infection a month 
prior, presented to the emergency department with fever, abdominal pain, 
diarrhea, and chest pain. On ECG, he was found to have focal ST-segment 
elevations in V3 through V6. Given the immediate concern for MI, an emergent 
echocardiogram was done and showed normal left ventricular systolic function 
with no regional dyskinesia and normal coronary artery diameters. A repeat ECG 
showed diffuse ST elevations in the inferior leads and T-wave inversions on V5 
and V6, confirming the diagnosis of myopericarditis. In conclusion, 
multisystem-inflammatory syndrome in children associated with COVID-19 (MIS-C) 
is a new entity describing a post-infectious inflammatory response in children 
with prior COVID-19 exposure. Cardiac involvement can include myopericarditis. 
Initial ECGs may show ST-changes suggestive of MI. However, serial ECGs and 
echocardiograms can differentiate between MI and myocarditis/myopericarditis. 
Even with COVID-19, MIs are extremely rare in children, and it is important to 
be aware of MIS-C and its cardiac complications.