An adolescent football player with chest pain

Approach to the child with chest pain

Children frequently present to a pediatric office or emergency department with the complaint of chest pain. Between 0.3% and 0.6% of visits to a pediatric emergency department are for chest pain. Unlike adult patients with chest pain, most studies have shown that children with chest pain rarely have serious organic pathology. Infrequently, a child with chest pain will present with significant distress and require immediate resuscitation. Most children with chest pain are not in extremis, and for many, the pain is not acute in nature.

Spontaneous pneumomediastinum in a marathon runner

A previously healthy 19 year old male presented to the emergency department complaining of soreness in his neck, difficulty taking a deep breath, and a "crinkly feeling" in his neck and upper chest after running a marathon. He was diagnosed with spontaneous pneumomediastinum. He did not require any intervention or hospitalisation and made a full recovery.

Chest pain in children and adolescents

The focus of this article is to explore chest pain in children and adolescents. Common causes of chest pain and the approach to its evaluation are reviewed. Special emphasis is given to the cardiac causes of pediatric chest pain and how it can be differentiated from more common benign etiologies.