Is Chest Pain in Children a Cause for Alarm?

Among 3,700 children and young adults between the ages of 7 to 22 who were evaluated for chest pain at Children’s Hospital Boston from 2000 to 2009, only 37 cases, or 1 percent, showed a cardiac cause, according to a recent study in the journal Pediatrics. The study also found that, even though chest pain in children is typically not serious, a child’s complaint to feeling such symptoms causes high anxiety for parents.

In truth, chest pains that send children to health clinics are usually the result of strained muscles, asthma, or even spicy foods, as opposed to what parents fear is a life-threatening heart condition. “The vast majority of children with chest pain were discharged with non-cardiac causes and none died,” said Dr. Susan Saleeb, lead researcher and a cardiologist at Children's Hospital. Saleeb also mentioned that annual screenings for chest pain at clinics rose steadily from about 240 to almost 500 children over the 10-year study period, despite predominantly benign tests results. Also, these screenings often involved unnecessary and expensive tests and resources.

The study found chest pain was linked to musculoskeletal distress for 1,345 youngsters, while 242 others had pulmonary problems; 108, gastrointestinal; 34, anxiety; and 4, drug-related issues. The cause was unknown in 1,928 cases. No cardiac-related deaths occurred among the children evaluated and discharged from the clinics during the study time frame, the Children's Hospital/Harvard study said. It was also noted by the study that the estimated incidence of pediatric sudden cardiac death ranges from 0.6 to 6.2 deaths per 100,000.

Dr. Jeffrey Boris, a cardiologist and associate professor of pediatrics at the University of Pennsylvania School of Medicine, said there are ways parents can determine if a child's chest pain is cardiac-caused and needs urgent attention. One technique is to push on the chest wall, and if the pain is reproducible, it's not a heart problem. Also, if the chest pain episode is brief, or the child can move around and participate in activities, it's not cardiac-related.

Boris also pointed out signals that indicate something is wrong are chest pains accompanied by fever, sweating, trouble breathing, or a very rapid heart rate. While help should be sought immediately, the episode is still unlikely to be cardiac-caused in children.

Around the Web

Children's Chest Pain Rarely Cause for Alarm: Study [US News & World Report]

Study: Children's Chest Pain Rarely Cause for Alarm [Visalia Times-Delta]