Background: Myocardial ischemia is a severe and unknown complication in children with sickle cell anemia.
Case reports: Two cases of myocardial ischemia complicated by syncope in one (8-year-old) and cardiomyopathy in the other (3-year-old) are reported.
Conclusion: Chest pain in children with sickle cell anemia should require ECG and, in case of hypokinetic cardiomyopathy, a myocardial SPECT. More aggressive therapy of sickle cell anemia should be considered in case of documented myocardial ischemia.