<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902025000301701</article-id>
<article-id pub-id-type="doi">10.29193/rmu.41.3.10</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Síndrome coronario agudo: una causa excepcional de dolor torácico en pediatría]]></article-title>
<article-title xml:lang="en"><![CDATA[Acute coronary syndrome: an exceptional cause of chest pain in pediatrics]]></article-title>
<article-title xml:lang="pt"><![CDATA[Síndrome coronariano agudo: uma causa excepcional de dor torácica em pediatria]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barbosa]]></surname>
<given-names><![CDATA[Lucía]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Casuriaga]]></surname>
<given-names><![CDATA[Ana Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[Alicia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Giachetto]]></surname>
<given-names><![CDATA[Gustavo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Regional de Tacuarembó  ]]></institution>
<addr-line><![CDATA[Tacuarembó ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Pereira Rossell  ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de la República Oriental del Uruguay Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>41</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902025000301701&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902025000301701&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902025000301701&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: las causas cardíacas de dolor torácico en niños y adolescentes son poco frecuentes, pero potencialmente graves. Las anomalías de las arterias coronarias constituyen el 2,2 % de las cardiopatías congénitas.  Objetivo: describir un caso clínico de dolor torácico de causa cardíaca, con énfasis en el proceso diagnóstico.  Caso clínico: varón de 13 años. Presenta síncopes de esfuerzo y ángor clase funcional II-III de tres meses de evolución durante la realización de ejercicio físico. Consulta por síncope durante la práctica de fútbol. Concomitantemente, refiere dolor torácico, opresivo, muy intenso, en todo el precordio, sin irradiaciones. Examen: normal. Electrocardiograma: infra desnivel del segmento ST en DI, DII y V2-V6. Test de troponinas: negativo. Radiografía de tórax y ecocardiograma: normales. Se inicia tratamiento con morfina intravenosa, nitritos transdérmicos, ácido acetilsalicílico y enoxaparina. Una hora después, ECG: renivelación del ST. A las 12 horas: test cualitativo de troponinas positivo. Enzimograma cardíaco: CPK 965 U/L y CPK-MB 67. Cineangiocoronariografía: origen coronario anómalo del tronco coronario izquierdo. Angiotomografía: tronco coronario izquierdo nace del seno coronario derecho, con un trayecto intramural e intraarterial. Se realizó creación de neoostium izquierdo mediante fijación del endotelio a la pared. Evolución: favorable.  Discusión: resulta fundamental que los profesionales que asisten a niños y adolescentes estén familiarizados con los principales aspectos a considerar de la anamnesis y el examen físico, a fin de pesquisar adecuadamente cardiopatías congénitas y adquiridas, según las recomendaciones vigentes. Esto contribuirá al diagnóstico precoz y al tratamiento oportuno de estas patologías y podrá modificar sensiblemente el pronóstico, tal como ocurrió en el caso analizado.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Cardiac causes of chest pain in children and adolescents are uncommon but potentially serious. Coronary artery anomalies account for 2.2% of congenital heart diseases.  Objective: To describe a clinical case of chest pain of cardiac origin, with emphasis on the diagnostic process.  Case report: A 13-year-old male presented with exertional syncope and functional class II&#8211;III angina of three months&#8217; evolution during physical activity. He sought medical attention after a syncopal episode during a football match. Simultaneously, he experienced very intense, oppressive chest pain involving the entire precordial area, without radiation. Physical examination: normal. Electrocardiogram: ST-segment depression in leads DI, DII, and V2&#8211;V6. Troponin test: negative. Chest X-ray and echocardiogram: normal. Intravenous morphine, transdermal nitrates, acetylsalicylic acid, and enoxaparin were initiated. One hour later, ECG: ST-segment normalization. At 12 hours: qualitative troponin test positive. Cardiac enzyme panel: CPK 965 U/L and CPK-MB 67. Coronary angiography: anomalous origin of the left coronary trunk. CT angiography: the left coronary trunk originated from the right coronary sinus, with an intramural and interarterial course. A neo-ostium of the left coronary artery was created by fixing the endothelium to the vessel wall. Outcome: favourable.  Discussion: It is essential that healthcare professionals involved in the care of children and adolescents be familiar with the key aspects of history-taking and physical examination in order to adequately detect congenital and acquired heart diseases in accordance with current guidelines. This contributes to early diagnosis and timely treatment of these conditions and can significantly alter the prognosis, as was the case in the present report.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução: As causas cardíacas de dor torácica em crianças e adolescentes são pouco frequentes, porém potencialmente graves. As anomalias das artérias coronárias representam 2,2 % das cardiopatias congênitas.  Objetivo: Descrever um caso clínico de dor torácica de origem cardíaca, com ênfase no processo diagnóstico.  Relato de caso: Paciente do sexo masculino, 13 anos. Apresenta síncopes aos esforços e angina classe funcional II&#8211;III com evolução de três meses durante a prática de atividade física. Procurou atendimento por síncope ocorrida durante jogo de futebol. Concomitantemente, referiu dor torácica opressiva, muito intensa, em todo o precórdio, sem irradiação. Exame físico: normal. Eletrocardiograma: infra desnivelamento do segmento ST em DI, DII e V2&#8211;V6. Teste de troponinas: negativo. Radiografia de tórax e ecocardiograma: normais. Iniciado tratamento com morfina intravenosa, nitratos transdérmicos, ácido acetilsalicílico e enoxaparina. Após uma hora, ECG: renivelamento do ST. Após 12 horas: teste qualitativo de troponinas positivo. Enzimograma cardíaco: CPK 965 U/L e CPK-MB 67. Cineangiocoronariografia: origem anômala do tronco coronariano esquerdo. Angiotomografia: o tronco coronariano esquerdo nasce do seio coronariano direito, com trajeto intramural e interarterial. Foi realizada a criação de um neoóstio esquerdo mediante fixação do endotélio à parede arterial. Evolução: favorável.  Discussão: É fundamental que os profissionais que assistem crianças e adolescentes estejam familiarizados com os principais aspectos da anamnese e do exame físico, a fim de identificar adequadamente cardiopatias congênitas e adquiridas, conforme as recomendações vigentes. Isso contribui para o diagnóstico precoce e o tratamento oportuno dessas patologias, podendo modificar significativamente o prognóstico, como ocorreu no caso relatado.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Dolor precordial]]></kwd>
<kwd lng="es"><![CDATA[Arteria coronaria anómala]]></kwd>
<kwd lng="es"><![CDATA[Niños]]></kwd>
<kwd lng="en"><![CDATA[Precordial pain]]></kwd>
<kwd lng="en"><![CDATA[Anomalous coronary artery]]></kwd>
<kwd lng="en"><![CDATA[Children]]></kwd>
<kwd lng="pt"><![CDATA[Dor precordial]]></kwd>
<kwd lng="pt"><![CDATA[Artéria coronária anômala]]></kwd>
<kwd lng="pt"><![CDATA[Crianças]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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