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AimsChest pain is a common disease in children. Most cardiac specialists use echocardiography to evaluate the etiology of and screen for children’s cardiac chest pain. We analyzed the etiology and echocardiography results of children with chest pain in pediatric cardiology clinics, clarified the disease spectrum and evaluated the diagnostic value o...
Citations
In recent times, most children and adolescents with chest pain of non-cardiac origin are diagnosed with some form of musculoskeletal disorder. Scoliosis is a three-dimensional deformity of the spine and the most common musculoskeletal disease in children. Chest pain in individuals with scoliotic spinal deformities most likely comes from the subluxation of the ribs and the direct and intermittent pressure on the nerve passing under the rib, which is nociceptive in character; the triggers are usually a deep inhale or the performance of the Valsalva manoeuvre. This is a case report of a 15-year-old girl with a scoliotic spinal deformity and chest pain from the General Hospital "Dr Laza K. Lazarević" in Šabac
Pediatric chest pain is a common chief complaint in the emergency department. Not surprisingly, children with chest pain are usually brought to the emergency department by their parents out of fear of heart disease. However, chest pain in the pediatric population is generally a benign disease. In this review, we have identified musculoskeletal pain as the most prevalent etiology of chest pain in the pediatric population, accounting for 38.7–86.3% of cases, followed by pulmonary (1.8–12.8%), gastrointestinal (0.3–9.3%), psychogenic (5.1–83.6%), and cardiac chest pain (0.3–8.0%). Various diagnostic procedures are commonly used in the emergency department for cardiac chest pain, including electrocardiogram (ECG), chest radiography, cardiac troponin examination, and echocardiography. However, these examinations demonstrate limited sensitivity in identifying cardiac etiologies, with sensitivities ranging from 0 to 17.8% for ECG and 11.0 to 17.2% for chest radiography. To avoid the overuse of these diagnostic tools, a well-designed standardized algorithm for pediatric chest pain could decrease unnecessary examination without missing severe diseases.
Background: Chest pain is a common disease in children. Chest pain is the second most common symptom referred to by paediatric cardiologists after cardiac murmurs. Objective: In this prospective study, we aimed to evaluate clinical characteristics and causes of chest pain in children admitted to our paediatric cardiology outpatient clinics. Methods: We conducted this prospective study among 446 patients with chest pain in a tertiary care hospital from 1 June 2017 to 1 June 2020. The demographic data and clinical characteristics of the patients were analysed. All patients were evaluated with a medical history, physical examination, laboratory tests, electrocardiogram and echocardiogram and if necessary telecardiogram, 24-hour electrocardiogram monitoring, exercise stress test and psychological evaluation were made. Results: The ratio of admissions with acute pain was 4% when 20% of the patients had chronic chest pain. The most common symptoms associated with chest pain were shortness of breath and palpitations. The non-cardiac causes were as follows: 25% musculoskeletal, 14% psychological, 9% respiratory, and 7% gastrointestinal, respectively. We found cardiac chest pain in 49 (11%) of patients. Idiopathic chest pain was found in 153 (34%) patients. Conclusions: Our study showed that the aetiology of chest pain in children and adolescents admitted with chest pain is mostly due to non-cardiac causes. We found the slightly frequency of elevated rate for cardiac aetiologies of paediatric chest pain compared to the literature. We suggest that in addition to anamnesis and careful examination, further investigation, if necessary, is important in determining the aetiology of chest pain.
Objective
The present study aimed to investigate the relationship between unexplained chest pain in children with parents’ mental problems, parental attitudes, family functionality, and the child’s mental problems.
Material and Method
A total of 433 children (between 11 and 18 years of age) applied to the Pediatric Cardiology Outpatient Clinic due to chest pain in the last year. A clinical interview was conducted by a child psychiatrist with 43 patients and 33 controls included in the study due to unexplained chest pain.
Results
Family history of physical illness was significantly higher in the chest pain group. When evaluated in terms of psychosocial risk factors, life events causing difficulties, derangement in the family, loss of a close person, and exposure to violence were statistically significantly higher in the group with chest pain. Mental disorders were observed in 67.4% of the children in the chest pain group as a result of the clinical interview. The total score of the DSM-5 somatic symptoms scale, which evaluates other somatic complaints in the chest pain group, was also significantly higher. When the family functions of both groups were evaluated, communication, emotional response, behaviour control, and general functions sub-dimensions were statistically significantly higher in families in the chest pain group.
Conclusion
We recommend that psychiatric evaluation be included in diagnostic research to prevent unnecessary medical diagnostic procedures in children describing unexplained chest pain, as well as to prevent the potential for diagnosing mental disorders in both children and adults.
Introduction. Cardialgia is a common reason for seeking medical care in the practice of the pediatrician and pediatric cardiologist. The combination of cardialgia and syncope in children can pose a health risk, leading to possible injuries, and is a factor of fear and anxiety in these families. Insufficient information on the pathophysiological basis of the development of cardialgia and syncope in children and the absebce of clear criteria for their prognosis and prevention were the reasons for a detailed study of the literature related to this issue.
The aim of the work was to systematize the current literary data on the causes of cardialgia and syncope in children and to determine directions for further study of the problem to improve monitoring by pediatricians and pediatric cardiologists.
Materials and methods. We searched for scientific articles using the keywords pediatric chest pain and syncope in the Pubmed, UpToDate 2022, Customer Service, and RSCI databases. Sixty publications were selected for analysis.
Results and discussion. Cardialgia is pain in the heart region, which in combination with fainting can be a symptom of a large number of diseases, which determines the different approach of medical specialists involved in the treatment of diseases of the cardiovascular system, and requires a special diagnosis. Cardialgia is characterized by polymorphism of both complaints and subjective sensations, and objective data. All this is caused by a variety of etiopathogenesis of this symptom.
Conclusion. Cardialgia is a current problem in pediatric practice. This literature review summarizes the information accumulated over several years on the diagnosis of cardialgia and syncope in children and determines the trajectory of further study of the problem.
