Skip to main content Accessibility help
×
Home

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

  • Ahmet Sert (a1), Ebru Aypar (a1), Dursun Odabas (a1) and Cem Gokcen (a2)

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.

Copyright

Corresponding author

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

References

Hide All
1. Balfour, IC, Rao, PS. Chest pain in children. Indian J Pediatr 1998; 65: 2126.
2. Evangelista, JA, Parsons, M, Renneburg, AK. Chest pain in children: diagnosis through history and physical examination. J Pediatr Health Care 2000; 14: 38.
3. Tunaoglu, FS, Olgunturk, R, Akcabay, S, Oguz, D, Gucuyener, K, Demirsoy, S. Chest pain in children referred to a cardiology clinic. Pediatr Cardiol 1995; 16: 6972.
4. Zavaras-Angelidou, KA, Weinhouse, E, Nelson, DB. Review of 180 episodes of chest pain in 134 children. Pediatr Emerg Care 1992; 8: 189193.
5. Geggel, RL. Conditions leading to pediatric cardiology consultation in a tertiary academic hospital. Pediatrics 2004; 114: 409417.
6. Fyfe, DA, Moodie, DS. Chest pain in pediatric patients presenting to a cardiac clinic. Clin Pediatr 1984; 23: 321324.
7. Hanson, CL, Hokanson, JS. Etiology of chest pain in children and adolescents referred to cardiology clinic. WMJ 2011; 110: 5862.
8. Friedman, KG, Kane, DA, Rathod, RH, et al. Management of pediatric chest pain using a standardized assessment and management plan. Pediatrics 2011; 128: 239245.
9. American Academy of Pediatrics. National Cholesterol Education Program: report of the expert panel on blood cholesterol levels in children and adolescents. Pediatrics 1992; 89: 525584.
10. Daniels, SR, Greer, FR. Committee on nutrition. Lipid screening and cardiovascular health in childhood. Pediatrics 2008; 122: 198208.
11. The American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edn. text revision (DSM-IV-R). American Psychiatric Association, Washington, DC, 2001.
12. Selbst, SM. Approach to the child with chest pain. Pediatr Clin North Am 2010; 57: 12211234.
13. Gumbiner, CH. Precordial catch syndrome. South Med J 2003; 96: 3841.
14. Cava, JR, Sayger, PL. Chest pain in children and adolescents. Pediatr Clin North Am 2004; 51: 15531568.
15. Selbst, SM, Ruddy, RM, Clark, BJ, Henretig, FM, Santulli, T Jr. Pediatric chest pain: a prospective study. Pediatrics 1988; 82: 319323.
16. Selbst, SM. Chest pain in children. Pediatrics 1985; 75: 10681070.
17. Rowe, BH, Dulberg, CS, Peterson, RQ, Vlad, P, Li, MM. Characteristics of children presenting with chest pain to a pediatric emergency department. Can Med Assoc J 1990; 143: 388394.
18. Selbst, SM. Chest pain in children. Pediatr Rev 1997; 18: 169173.
19. Massin, MM, Bourguignont, A, Coremans, C, Comté, L, Lepage, P, Gérard, P. Chest pain in pediatric patients presenting to an emergency department or to a cardiac clinic. Clin Pediatr 2004; 43: 231238.
20. Lipsitz, JD, Gur, M, Sonnet, FM, et al. Psychopathology and disability in children with unexplained chest pain presenting to the pediatric emergency department. Pediatr Emerg Care 2010; 26: 830836.
21. Driscoll, DJ, Glicklich, LB, Gallen, WJ. Chest pain in children: a prospective study. Pediatrics 1976; 57: 648651.
22. Eslick, GD. Epidemiology and risk factors of pediatric chest pain: a systematic review. Pediatr Clin North Am 2010; 57: 12111219.
23. Kwiterovich, PO Jr. Recognition and management of dyslipidemia in children and adolescents. J Clin Endocrinol Metab 2008; 93: 42004209.
24. Brown, JL, Hirsh, DA, Mahle, WT. Use of troponin as a screen for chest pain in the pediatric emergency department. Pediatr Cardiol 2012; 33: 337342.

Keywords

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

  • Ahmet Sert (a1), Ebru Aypar (a1), Dursun Odabas (a1) and Cem Gokcen (a2)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed