Chest Pain in Children: Is It Another "Growing Pain"?

Area of Science:

• Pediatric Medicine
• Cardiology
• Gastroenterology

Background:

• Chest pain is a frequent pediatric complaint, with 99% of cases having non-cardiac origins.
• Musculoskeletal causes are the most prevalent non-cardiac chest pain etiologies in children.
• Existing diagnostic labels for musculoskeletal chest pain may be applied too broadly.

Purpose of the Study:

• To review proposed etiologies of pediatric chest pain.
• To evaluate the evidence supporting current diagnostic and management approaches.
• To differentiate benign musculoskeletal chest pain from pain with unidentified causes.

Main Methods:

• Comprehensive literature review of pediatric chest pain etiologies.
• Analysis of diagnostic criteria and clinical examination findings.
• Evaluation of emerging treatment modalities, including psychiatric and mindfulness-based interventions.

Main Results:

• Musculoskeletal chest pain is the most common non-cardiac cause in children.
• Accurate diagnosis requires a detailed history, physical exam, and potentially an electrocardiogram and laboratory tests.
• Chest pain without an identifiable cause may indicate somatization, benefiting from psychiatric evaluation.

Conclusions:

• Providers must differentiate benign musculoskeletal chest pain from undiagnosed causes.
• Objective physical findings or a plausible history are crucial for diagnosing musculoskeletal chest pain.
• Emerging interventions like mindfulness may benefit children with somatization-related chest pain.