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Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
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Chest Pain in Pediatrics.

Tisha K Yeh, Jay Yeh

    Pediatric Annals
    |December 19, 2015
    PubMed
    Summary

    Chest pain in children is usually not heart-related, despite frequent referrals to pediatric cardiologists. This review clarifies causes and guides appropriate evaluation, reducing unnecessary cardiac testing.

    Area of Science:

    • Pediatric Cardiology
    • Cardiovascular Diseases
    • Pediatric Health

    Background:

    • Chest pain is a common symptom in children and adolescents, often leading to pediatric cardiology referrals.
    • While concerning for serious cardiac conditions like sudden cardiac death, most pediatric chest pain cases have non-cardiac origins.
    • Extensive evaluations for pediatric chest pain can result in significant healthcare costs and patient burden.

    Purpose of the Study:

    • To review cardiac and non-cardiac causes of chest pain in pediatric patients.
    • To emphasize key elements of history taking and physical examination for evaluating pediatric chest pain.
    • To provide guidance on appropriate diagnostic pathways and criteria for referral to a pediatric cardiologist.

    Main Methods:

    • Literature review of pediatric chest pain etiologies.

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  • Analysis of diagnostic approaches including history, physical examination, and investigations.
  • Synthesis of evidence to define appropriate referral indications for pediatric cardiology.

    • Main Results:

    • The majority of pediatric chest pain cases stem from non-cardiac causes.
    • A thorough history and physical examination are crucial for differentiating serious from benign conditions.
    • Unnecessary cardiac investigations and referrals can be minimized with a structured evaluation.

    Conclusions:

    • Most pediatric chest pain does not require cardiac workup, despite parental and physician concerns.
    • Accurate assessment can identify patients needing further cardiac evaluation, avoiding over-investigation in others.
    • Appropriate management strategies reduce healthcare utilization and costs while ensuring timely diagnosis of critical conditions.