Chest pain in children is not uncommon. It can be quite distressing for the child and for parents. The causes of chest pain in children are quite different from that seen in adults. Here we discuss the various causes of chest pain in children and adolescents. We will also discuss when we need to get worried.
What is the most common cause of chest pain in children?
Most common cause of chest pain in children is musculoskeletal chest pain or pain originating from the muscles or bones in the chest. This could be due to a spasm or cramp of the chest wall muscles. Musculoskeletal pain is short lasting but can be quite painful. Bad coughs often during a cold or asthma can also cause chest pain in children. “Costochondritis" or swelling of the cartilage connecting with the bones of the chest is also a common cause of musculoskeletal chest pain in children.
What are the other common causes of chest pain in children?
There are other common causes of chest pain in children as well. Pneumonia or lung infection is a common cause of chest pain especially if associated with fluid around the lungs called pleural effusion. Children with asthma also commonly complain of chest pain along with tightness in chest. Acid reflux from the stomach into the esophagus can cause burning chest pain behind the breast bone. This is called as gastroesophageal reflux disease or heartburn. Stress or anxiety can also cause chest pain in children. Chest pain associated with stress or anxiety is often dull or non-specific. Triggers could be loss of a relative, school examinations, discordance in the family, etc.
Can chest pain in children be caused by a heart problem?
Heart problems causing chest pain in children are uncommon compared to adults. Cardiac causes of chest pain could be pericarditis (inflammation of the heart lining), mitral valve prolapse (abnormality of the valve) and arterial aneurysm (stretching and out-pouching of the vessel). Coronary artery anomalies leading to chest pain can happen in children due to abnormal positioning of blood vessels since birth or acquired causes like Kawasaki’s disease.
How do we evaluate a child presenting with chest pain?
A thorough case history of the child and physical examination is the first step in evaluation of a child presenting with chest pain. Need for any investigations depends on the findings. Some children might require Chest Xray, ECG, lung function tests, etc. Occasional children might require an echocardiogram if cardiac causes are suspected.
If your child is having chest pain you need to get in touch with a pediatric pulmonologist for opinion, evaluation and treatment.