Chest Pain - Children

Chest Pain in Children

Besides adults, chest pain is frequently reported in children too and is one of the reasons for frequent referrals to the pediatric cardiologists. But it is rarely life threatening. Generally chest pain is the seventh commonest reason for referring a child to the emergency department, however in one of the studies it was found that half the kids referred to casualty department below 12 years were for chest pain. An equal number of males and females usually present with chest pain to the doctors.

The etiology of chest pain in children is mostly idiopathic and is rarely heart-related. Careful evaluation has revealed that most of the time the chest pain is due to depression arising from socio-familial reasons.

Children also suffer chest pain due to problems in the musculoskeletal and the pulmonary system and also due to factors associated with the Gastro intestinal (GI) tract.

Another common cause of chest pain in children is "Costochondritis" and usually affects pre-adolescents and teenagers. Costochondritis is caused by an inflammation of the joint between the breast bone (sternum) and the ribs. On pressing this area on the chest, the pain may get aggravated.(3^✔)

In a study published by Yildirim A, Karakurt C, Karademir S et al in Int Pediatr. 2004; 19(3):175-179 entitled 'Chest pain in children' they conclude that chest pain is rarely due to cardiac disease and etiology is usually obscure. They studied 300 children who presented with chest pain and found that--[128 (42.7%) were girls and 172 (57.3%) were boys]. The ages of the girls and boys ranged from 3 to 17 years (mean 9.6 years) and 3 to 15 years (mean 10.4 years). The course time during chest pain, was over one month in 207 (68.8%) of the patients. Localization was on the left pericardium in 226 (75.3%) of the patients. The reason for chest pain was idiopathic or cause unknown in 189 (63.4%) of the patients. Psychiatric, cardiac, gastrointestinal, pulmonary, and musculoskeletal causes were present in 56 (18.7%), 24 (8%), 14 (4.7%), 9 (3%), and 5 (1.6%) of the patients. One patient presented with BCG lymphadenitis (axillary); one patient with thelarche; and one patient with gynecomastia had chest pain.

Reference:

1. Chest Pain or Discomfort - (https://www.ncbi.nlm.nih.gov/books/NBK416/)
2. Gender Matters: Heart Disease Risk in Women - (https://www.health.harvard.edu/heart-health/gender-matters-heart-disease-risk-in-women)
3. Chest Pain - Children - (https://www.cincinnatichildrens.org/health/c/chest)
4. Angina (Chest Pain) - (https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain)
5. Musculoskeletal Chest Wall Pain - (https://www.racgp.org.au/afp/2015/august/musculoskeletal-chest-wall-pain/)
6. Angina and Other Causes of Chest Pain - (http://www.secondscount.org/heart-condition-centers/info-detail-2/whats-causing-your-chest-pain-2#.XiWSKMgzbIU )
7. Other Conditions May be Causes of Chest Pain - (https://www.health.harvard.edu/diseases-and-conditions/other-conditions-may-be-causes-of-chest-pain)
8. Chest pain - (https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/chest-pain)