By: Rayyan M. Anwer, MD, FAAP

Chest pains can be a common complaint in the pediatric age group and can be quite stress provoking. Fortunately “the incidence of a cardiac-related cause for chest pain in the pediatric population is exceedingly low, ranging from 0.2% to 1% of cases”.

Causes of chest pain can be generally from the muscles or the ribs, the ribs itself, the lungs, abdomen, heart, or anxiety related. Interestingly in over a third of pediatric cases, no clear cause of presenting chest pain could be established.

At the same time knowing what signs to watch out for and how urgently you need to seek medical ttention is very important. Keep in mind the key warning signs for chest pains that necessitate a STAT evaluation. Some of these are chest pains with:

• Shortness of breath, or difficulty breathing
• Dizziness, feeling lightheaded or syncope
• Exertion or activity
• A bad headache, or pain or weakness in any other part of your body
• Irregular heartbeats (palpitations)
• Laying flat and improvement leaning forward
• Fevers

Documenting and logging occurrences of chest pain and associated symptoms will be extremely useful for your medical provider to help narrow down the auses and avoid unnecessary testing. Below are some key points to log:

• Timing and duration (relationship to meals, does it occur on exertion,or during sleep, etc)
• Site of pain and reproducibility (for example, the ability to bring on the pain by pushing on a particular location)
• Quality (sharp/ stabbing/ dull/ etc.) and radiation (does the pain start at one spot and then travel to another spot)
• Aggravating and relieving factors. Associated symptoms (for example, dizziness, light headed or syncope, Shortness of Breath, FEVERS, Cough, intense emotions or anxiety)
• Personal and family history of cardiac conditions, or sudden death
• Previous injury

Although chest pains can be quite common in the pediatric population, they should always be taking seriously. Our hope is that the above summary can id your investigation as you bring your concerns up to your medical provider.

Source: Pediatric Chest Pain by Gal Barbut, MD, Joshua P. Needleman, MD.
Published in the September 2020 issue of Pediatrics in Review (Vol. 41 No. 9)