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Clinical characteristics and causes of chest pain in 380 children referred to a paediatric cardiology unit

Published online by Cambridge University Press:  05 July 2012

Ahmet Sert ,
Ebru Aypar ,
Dursun Odabas  and
Cem Gokcen
Ahmet Sert*
Affiliation:
Department of Pediatric Cardiology, Konya Training and Research Hospital, Konya, Turkey
Ebru Aypar
Affiliation:
Department of Pediatric Cardiology, Konya Training and Research Hospital, Konya, Turkey
Dursun Odabas
Affiliation:
Department of Pediatric Cardiology, Konya Training and Research Hospital, Konya, Turkey
Cem Gokcen
Affiliation:
Department of Child and Adolescent Psychiatry, Medical Faculty, Gaziantep University, Gaziantep, Turkey
*
Correspondence to: Dr A. Sert, MD, Department of Pediatric Cardiology, Konya Training and Research Hospital, 42080 Konya, Turkey. Tel: +90 332 323 67 09; Fax: +90 332 323 6723; E-mail: ahmetsert2@hotmail.com
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Abstract

Background

Chest pain is a common presenting complaint to paediatrics, paediatric cardiology, and paediatric emergency departments. In this study, we prospectively evaluated clinical characteristics and causes of chest pain in children referred to our paediatric cardiology unit.

Methods

A total of 380 children were included. Associated symptoms and past and family histories were evaluated. All patients underwent physical examination. The following studies were performed: complete blood count in all patients; fasting lipid profiles in overweight and obese children and children with a family history of premature cardiovascular disease; and electrocardiogram, chest X-ray, and echocardiogram in all patients. If necessary, 24-hour electrocardiogram monitoring or exercise stress tests were performed. Patients with a history of positive psychological findings were evaluated by a child psychiatrist.

Results

The most common causes of chest pain were musculoskeletal disorders (37.1%), idiopathic chest pain (29.2%), and miscellaneous disorders, for example precordial catch syndrome (15%), respectively. Only 1 of 380 (0.3%) patients had chest pain due to a cardiac disorder. Electrocardiograms were abnormal in 4 of 380 (1.1%) patients. A total of 9 of 380 patients (2.3%) had dyslipidaemia.

Conclusions

Although a paediatric cardiology referral may provide reassurance to the primary care and emergency department physicians, our results show that cardiac aetiologies for paediatric chest pain are very rare. We think that many patients in our study were adequately evaluated only by careful history, and physical examination. Therefore, we suggest that it may not be necessary to use echocardiogram in the routine evaluation of children with chest pain.

Keywords

Dyslipidaemiaechocardiogramelectrocardiogramaetiology
Type
Original Articles
Information
Cardiology in the Young , Volume 23 , Issue 3 , June 2013 , pp. 361 - 367
Copyright
Copyright © Cambridge University Press 2012 

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