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Children with chest pain visiting the emergency department

Chien-Heng Lin1, Wei-Ching Lin, Yung-Jen Ho

  • 1Department of Pediatrics, Jen-Ai Hospital, Taichung, Taiwan.

Pediatrics and Neonatology
|October 25, 2008
PubMed

Insights

Idiopathic chest pain is the most frequent reason for pediatric emergency department visits. A thorough physical exam is crucial for diagnosis, potentially avoiding unnecessary tests for children with chest pain.

Area of Science:

  • Pediatric Emergency Medicine
  • Cardiology
  • Pulmonology

Background:

  • Chest pain is a frequent pediatric emergency department (ED) complaint.
  • Serious organic causes, such as cardiac disease, are rare in children presenting with chest pain.
  • Understanding the etiology of pediatric chest pain is essential for appropriate management.

Purpose of the Study:

  • To assess and analyze the causes of chest pain in children visiting a pediatric ED.
  • To identify the most common diagnoses for pediatric chest pain.
  • To evaluate the utility of diagnostic examinations in pediatric chest pain cases.

Main Methods:

  • Retrospective review of medical records for children with chest pain (excluding trauma).
  • Data collected from September 2002 to June 2005 at a single medical center.
  • Inclusion of diagnostic test results such as chest radiograms, electrocardiograms, echocardiography, and panendoscopy.

Main Results:

  • Idiopathic chest pain was the most common diagnosis (59.2%).
  • Pulmonary causes (pneumonia, pneumothorax) accounted for 24.3%, musculoskeletal for 6.7%, and gastrointestinal for 5.8%.
  • Cardiac abnormalities were found in 2.0% of patients; 10.7% required hospital admission.

Conclusions:

  • Idiopathic chest pain is the leading cause of pediatric ED visits for this symptom.
  • A comprehensive physical examination is vital for diagnosing chest pain in children.
  • Clinical assessment can minimize the need for extensive and potentially unnecessary diagnostic testing.
Abstract

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