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Chest pain in children

Publication ,  Journal Article
Lang, JE; Colin, AA
Published in: Current Pediatric Reviews
August 1, 2006

Pain arising from the chest area creates anxiety in children and their parents, often leading to unnecessary activity restriction, school absences, and medical utilization. A thorough but pragmatic evaluation requires a grasp of the pathophysiology of several organ systems and an understanding of epidemiologic and behavioral patterns specific to children. Few symptoms in pediatrics test a clinician's skill more than chest pain. Though the etiology is frequently benign, it is often uncertain, and sprinkled among cases of chest pain are potentially fatal conditions. This review summarizes chest pain in children of all ages, with particular emphasis on adolescents. We review the organic causes including musculoskeletal trauma, strain and inflammation, respiratory conditions such as occult asthma, pneumonia and bronchitis, and the important role of esophageal disease. We discuss the relatively minor role of cardiac disease, but highlight the conditions that are vital to consider, such as arrhythmia, mitral valve disease, Kawasaki syndrome, Marfan syndrome, and cocaine use. Anxiety, depression, and other psychological factors often further complicate the presentation. A pediatrician's best tools are diagnostic acumen, which may be lifesaving, and supportive dialogue, to impart reassurance to a worried family. We explore the most common and most lethal causes by age, organ system, and predisposing illness. We review the neuroanatomic considerations important in visceral, chest wall, and mediastinal pain, and the sensation within the lung, airways, and pleurae. Lastly, we highlight pragmatic 'take-home' tips for the clinician, most of which involve good history-taking and physical examination, but also include the utility of basic testing that can detect the rare cases of fatal cardiopulmonary disease. © 2006 Bentham Science Publishers Ltd.

Duke Scholars

Published In

Current Pediatric Reviews

DOI

ISSN

1573-3963

Publication Date

August 1, 2006

Volume

2

Issue

3

Start / End Page

245 / 258

Related Subject Headings

  • Pediatrics
  • 3213 Paediatrics
  • 1117 Public Health and Health Services
  • 1114 Paediatrics and Reproductive Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lang, J. E., & Colin, A. A. (2006). Chest pain in children. Current Pediatric Reviews, 2(3), 245–258. https://doi.org/10.2174/157339606778019710
Lang, J. E., and A. A. Colin. “Chest pain in children.” Current Pediatric Reviews 2, no. 3 (August 1, 2006): 245–58. https://doi.org/10.2174/157339606778019710.
Lang JE, Colin AA. Chest pain in children. Current Pediatric Reviews. 2006 Aug 1;2(3):245–58.
Lang, J. E., and A. A. Colin. “Chest pain in children.” Current Pediatric Reviews, vol. 2, no. 3, Aug. 2006, pp. 245–58. Scopus, doi:10.2174/157339606778019710.
Lang JE, Colin AA. Chest pain in children. Current Pediatric Reviews. 2006 Aug 1;2(3):245–258.
Journal cover image

Published In

Current Pediatric Reviews

DOI

ISSN

1573-3963

Publication Date

August 1, 2006

Volume

2

Issue

3

Start / End Page

245 / 258

Related Subject Headings

  • Pediatrics
  • 3213 Paediatrics
  • 1117 Public Health and Health Services
  • 1114 Paediatrics and Reproductive Medicine