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Most pediatric chest pain is noncardiac, but what about otherwise healthy adolescents who have chest pain with features suggestive of ischemia? These authors describe the cases of nine such adolescents (8 males; age range, 12–20 years) who presented with chest pain to an Ohio children’s hospital emergency department during 11 years and whose symptoms and clinical course met the criteria for acute myocardial infarction. Comorbidities included migraine headache (2 patients) and attention-deficit/hyperactivity disorder (ADHD; 1 patient).
On electrocardiography, six patients had ST elevations in the inferior or inferolateral leads, one had normal findings, and two showed nonspecific ST-T changes. Three patients had nonsustained ventricular tachy…