[Chest pain in children and adolescents]

Chest pain is a frequent complaint in children and adolescents. True organic disease is rare, especially cardiac disease is infrequently found as the underlying cause. Organic disease is associated with acute onset, fever, chest pain exclusively with physical activity and with abnormal physical findings in the patient. In the majority the symptom is not caused by organic disease, in these cases longer duration of symptoms is typically found as well as higher patient age, typically teenagers. Stress factors such as troubles in school and family need to be asked for. Detailed history and a meticulous physical examination usually allow for a clear delineation of the problem, making additional diagnostic work-up unnecessary in most instances. Laboratory tests remain indicated only upon suspicious clinical or anamnestic signs and are not efficient as widely used screening tools.