Common Causes Of Chest Pain In Children, Signs And Treatment

Chest pain in children may occur due to several reasons; however, in most cases, the underlying cause is not related to the heart but to chest wall problems. The chest wall is the structure that encloses and protects the lungs, ribs, and sternum (1).

Chest pain is mainly divided into two types: cardiac chest pain and non-cardiac chest pain (2). However, children mostly experience non-cardiac chest pain.

Read on to know more about the common causes of chest pain in children and its diagnosis and treatment.

Is Chest Pain In Children Normal?

Chest pain in children is considered one of the most common reasons for a visit to a pediatric cardiologist. However, in most children with chest pains, the symptoms eventually go away (3).

The most common reasons for chest pains in children are usually related to the chest wall or the musculoskeletal system. Research shows that in about 98% of the children who complain of sharp pain in the chest, the reason is non-cardiac, meaning it is not related to the heart (2).

Common Causes Of Chest Pain In Children

“Kids might have chest pain from doing different or more strenuous-than-normal activities,” says Dr. Kenneth Zahka, MD, a pediatric cardiologist at Cleveland Clinic (4).

Chest pains in children can be caused due to problems in the lungs, the ribs, the chest wall muscles, the diaphragm, or the joints between the rib cage and the breast bone.

If there is a known family history of chest pains, then your child might be more susceptible to having it.

Most children who complain of chest pains usually experience musculoskeletal chest pain, which originates from the muscles or the bones in the chest and their connections. The following are the most common causes of musculoskeletal chest pain in children (5).

• A spasm or cramp of the chest wall muscles and nerves, also called precordial catch syndrome
• Cold or cough
• Costochondritis, pain caused due to the inflammation of the cartilages connecting the bones of the chest

Apart from the musculoskeletal causes of chest pain, the other common causes include (5)

• Pneumonia, which can cause irritation around the lungs and can be painful while breathing
• Asthma
• Gastroesophageal reflux disease or acid reflux
• Sometimes, children may describe emotional responses to stress and anxiety as chest pain
• Accumulation of air or fluid in the chest wall
• Inflammation of the chest wall
• Respiratory infection
• Underlying heart disease

Heart Conditions That Cause Chest Pain In Children

In a few rare cases, the following conditions might cause chest pain in children (1) (6).

• Pericarditis: It is an inflammation of the heart lining, the sac that surrounds the heart. It is usually caused by a treatable or self-limited condition and leads to sharp pain in the mid-sternum region and shoulders

• Myocarditis: It is a viral infection of the heart that can lead to an inflammation of the heart muscle.

• Arrhythmia: It is a condition associated with a problem in the rate or rhythm of the heartbeat. For example, the heartbeat might be too fast, too slow, or have an irregular rhythm overall, leading to chest pain in children (7).

• Abnormalities in the coronary artery: Any abnormalities in the coronary arteries might lead to a limited supply of oxygenated blood to the heart, eventually causing chest pain

• Dissection or tearing of the aorta: The tearing of the inner layers of the aorta, the main artery in the body, might also cause chest pain in children

Signs That Indicate A Cardiac Condition In Your Child

Chest pains related to heart conditions are rarely seen in children. However, if your child shows any of the following signs (5), you might want to consult a pediatric cardiologist.

• Chest pain during or after physical exertion or exercise
• Feeling of pain and pressure in the chest that does not go away easily
• An unexpected decrease in physical activity over weeks or days
• Chest pain followed by passing out or nearly passing out
• Chest pain in children who have a genetic predisposition to high cholesterol
• Chest pain in a child born with congenital heart disease

When Should You Consult A Doctor?

Chest pain in children is mostly due to benign or self-limiting conditions. Heart disease or other serious illnesses might be an unlikely cause to consider.

However, if your child has severe chest pain and, along with it, has been showing signs of fever, troubled breathing, pain while taking deep breaths, sweating, or an increased heart rate of greater than 200, consult your pediatric cardiologist and perform tests to rule out underlying conditions (6).

Treatment For Chest Pain In Children

The signs and symptoms of chest pain in children usually disappear within a few days (4).

In case the symptoms persist, the doctors would generally suggest pain relievers or anti-inflammatory medicines, such as ibuprofen, and advise the child to avoid activities that might aggravate the pain.

Chest pain in children usually goes away within a day or two, either naturally or by administering pain relievers. However, if the symptoms persist and the pain lingers on, it is best to consult your pediatric cardiologist at the earliest.

References

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Reviewer

Dr. Dur Afshar AghaMS

   

Dr. Dur Afshar Agha is a consultant pediatrician with around 26 years of experience in various medical facilities both in Pakistan and Saudi Arabia. She has headed the Department of Preventive Pediatrics at the prestigious, Children’s Hospital and Institute of Child Health in Pakistan and is a life member of the Pakistan Paediatric Association.

Read full bio of Dr. Dur Afshar Agha