The causes of myocardial ischemia in children are generally considered to be related to congenital heart disease, viral myocarditis and Kawasaki disease. 1. Congenital heart disease: such as congenital arterial ductus arteriosus, ventricular septal defect, or congenital vascular developmental abnormality, which can lead to blood shunt, insufficient blood supply to myocardium, and myocardial ischemia such as palpitation, shortness of breath, and fatigue. 2. Viral myocarditis: Viruses directly affecting the myocardium or indirectly infecting the myocardium with viruses of the upper respiratory tract or viral gastroenteritis may cause damage to the myocardium and lead to myocardial ischemia, which is often manifested as fever, panic, chest tightness, chest pain, and so on. 3. Kawasaki disease: it is an acute self-limiting vasculitis disease that occurs in children under 5 years of age, and some of the patients involve coronary arteries, resulting in aneurysmal dilatation or stenosis, insufficient blood supply to the myocardium, and myocardial infarction or even sudden death. It is recommended that children with symptoms of myocardial ischemia should go to the hospital in time to improve the examination and find out the cause of the disease.