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By: Rayyan 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 chestpain in the pediatric population is exceedingly low, ranging from 0.2% to 1% of cases”. Causes of chest pain can originate from the muscles, ribs, lungs, abdomen, heart, or even anxiety. In over a third of pediatric cases, no clear cause of presenting chest pain can be established.

Knowing what signs to watch out for and when you need to seek medical attention is especially important. Keep in mind the key warning signs for chest pains that necessitate a STAT evaluation. Some of these include chest pains with:

-Shortness of breath or difficulty breathing

-Dizziness, feeling lightheaded or syncope

-Exertion or activity

-A bad headache, or pain/weakness in any other part of your body.

-Irregular heartbeats (palpitations)

-Lying flat with improvement leaning forward.


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

Time 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, lightheaded 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 taken seriously. Our hope is that the above summary can aid 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)

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November 2020