We invited Vimal Jayswal, MD, PPG – Specialty Pediatrics Cardiology and Kaylee Stout, RN-BSN, PPG – Specialty Pediatrics Cardiology, to explain the possible causes of chest pain in children and teens, the appropriate treatment and whether it’s possible the child will outgrow the discomfort.
How can a parent tell if a little one is experiencing chest pain?
Chest pain is a subjective feeling of pain, usually localized on the left side of the chest cavity. The chest pain could present as sharp, burning, heavy or squeezing in nature. Infants and young children would present with difficulty breathing, irritability, fussiness, feeding difficulty or sweating fever. Older children and adolescents could present with chest pain at rest or with activity. Chest pain with exertion could be a red flag for a significant heart problem.
When should a parent be concerned?
A parent should be concerned when a toddler/young child has chest pain along with difficulty breathing, irritability/fussiness, loss of consciousness, minimal activity, fever, sweating or an elevated heart rate (over 200). Some children may grab their chest if experiencing chest pain.
Which conditions could chest pain be associated with?
Chest pain in children could be caused by different diseases or illness, but some of the most common reasons for chest pain are musculoskeletal, irritation and inflammation of the muscles and bones. However, sometimes chest pain could be an initial sign of significant heart disease, including undiagnosed congenital heart disease (CHD), inflammation of the heart muscle or layers (myocarditis/pericarditis) or associated with arrhythmia or extra beats.
Non cardiac causes of chest pain:
- Precordial Catch Syndrome – Pain that occurs with inhalation that can be sharp and intense, with an unknown cause.
- Acid Reflux – Pain that can be characterized as a burning pain in the chest and stomach that can occur after meals.
- Costochondritis – Inflammation between the ribs and breastbone that could be caused by respiratory illness and coughing that is usually treated with an anti-inflammatory like ibuprofen.
Cardiac causes of chest pain:
- Coronary Artery Abnormalities – Abnormal size, positio, or course of these tiny vessels caused by congenital heart disease or acquired heart disease.
- Myocarditis/Pericarditis – Pain caused by inflammation of the heart's lining due to infection.
Which tests will be done to evaluate the chest pain?
Based on the history and symptoms, the doctor would determine which diagnostic tests would help evaluate the chest pain. Tests to evaluate chest pain could include a chest x-ray, electrocardiogram, echocardiogram, stress test, lung function tests and lab work.
What treatment is available?
Based on the child's symptoms and diagnosis, management could include reassurance, supportive care and ibuprofen for pain. Significant chest pain, secondary to cardiovascular causes, may require urgent further evaluation and treatment.
Can a child grow out of these conditions?
Musculoskeletal origin of chest pain usually has an excellent prognosis and most of the children outgrow the symptoms after reassurance and supportive care.
How can Parkview help?
Parkview has a dedicated pediatric cardiology staff available 24/7 to assess your child's chest pain if needed, while bringing a continuity of care.
