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Uncommon Causes of Chest Pain in Children: An Experience From a Tertiary Care Hospital
Nurul Islam1, Saroj K Tripathy2, Jitendriya Biswal3
1Pediatrics, Healthworld Hospitals, Durgapur, IND.
Insights
Pediatric chest pain is frequently psychogenic, often linked to anxiety and depression, especially with increased screen time. Most children improve with intervention, but a significant portion are lost to follow-up.
Area of Science:
- Pediatrics
- Cardiology
- Psychology
Background:
- Chest pain is a common pediatric complaint in emergency and outpatient settings.
- Etiology of pediatric chest pain in India requires further clarification.
- This study addresses the prevalence and causes of chest pain in children.
Purpose of the Study:
- Evaluate the primary causes of chest pain in children and adolescents.
- Describe demographic factors, symptoms, and outcomes.
- Identify contributing factors like screen time and internet addiction.
Main Methods:
- Retrospective analysis of 55 children (5-15 years) with chest pain.
- Data collected from July 2019 to June 2021.
- Review of case records for demographics, symptoms, etiology, and outcomes.
Main Results:
- Mean age 10.75 years; balanced male-female ratio.
- 83.6% of cases had psychogenic causes (anxiety, depression).
- 78.2% had >2 hours screen time; 23.6% had internet addiction.
Conclusions:
- Pediatric chest pain is often non-cardiac and psychogenic.
- Thorough history, examination, and basic tests are key for diagnosis.
- Referral to pediatric cardiology may be necessary, though causes are often behavioral.
Abstract:
Background Chest pain is one of the common complaints for emergency and outpatient department (OPD) visits in children and adolescents. Chest pain accounts for 0.6% of pediatric emergency visits and 2.5% of pediatric outpatient consultations. The prevalence of chest pain and the etiological factors associated with children in India is unclear. The primary objective of this study was to evaluate the etiology of chest pain in children and adolescents. The secondary objective was to describe the demographic characteristics and associated symptoms with chest pain and the outcomes of children after the intervention. Methodology A retrospective analysis of case records of 55 children aged between 5 and 15 years who attended the emergency or OPD of the hospital with the primary complaint of chest pain from July 1, 2019, to June 30, 2021, was done. Results The mean age of patients in our study was 10.75 ± 2.47 years. Of 55 children, 26 were males, and 26 were females (male-to-female ratio = 0.9). In total, 43 (78.2%) patients had screen time of more than two hours. Palpitation was recorded in 11 (20.4%) patients, whereas only four (7.3%) children had breathing difficulties. Of 55 children, 46 (83.6%) had psychogenic causes, six (10.9%) had organic reasons, and three had no identifiable cause of chest pain. Anxiety disorder (40%) and depression (21.8%) were the leading psychogenic causes of chest pain. Overall, 13 (23.6%) children had associated smartphone and internet addiction disorder. Of 55 children, 36 (63.6%) improved following an appropriate intervention. Five children had some or no improvement in chest symptoms. Finally, 15 (27.3%) children were lost to follow-up. Conclusions Chest pain is one of the common complaints in the pediatric age group needing referral to a pediatric cardiologist. The most common etiology associated with chest pain is often non-cardiac and psychogenic. Good patient history taking, clinical examination, and fundamental investigations are sufficient to unravel the etiology in most cases.
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