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[Chest pain in children: a practical approach].

Gaia Spaziani1, Iva Pollini1, Marianna Fabi2

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Summary

Pediatric chest pain is common, but rarely cardiac. Most cases are musculoskeletal or idiopathic, especially in males aged 10-14. Early diagnosis is key to avoid unnecessary tests and hospital stays.

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Area of Science:

  • Pediatric Cardiology
  • Emergency Medicine
  • Clinical Pediatrics

Background:

  • Childhood chest pain is a frequent reason for emergency department visits and pediatric consultations.
  • While often benign, it necessitates careful evaluation to rule out serious conditions.
  • The incidence peaks between 10-14 years, predominantly affecting males.

Purpose of the Study:

  • To summarize the common causes and diagnostic considerations for pediatric chest pain.
  • To emphasize the low incidence of cardiac origins in pediatric chest pain evaluations.
  • To highlight the importance of early and accurate diagnosis in managing pediatric chest pain.

Main Methods:

  • Review of existing literature on pediatric chest pain.
  • Analysis of common etiologies, including musculoskeletal and idiopathic causes.
  • Discussion of diagnostic pathways and the low prevalence of cardiac involvement.

Main Results:

  • The vast majority of pediatric chest pain cases are non-cardiac, often idiopathic or musculoskeletal.
  • Cardiac causes account for a small minority (0.5-1%) of pediatric chest pain presentations.
  • Prompt identification of concerning symptoms can streamline diagnosis and management.

Conclusions:

  • Most childhood chest pain is benign and does not require extensive cardiac workup.
  • Effective diagnostic strategies can prevent unnecessary investigations and prolonged hospitalizations.
  • Focusing on early identification of red flags is crucial for appropriate pediatric chest pain management.